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CARDIOVASCULAR ANESTHESIOLOGY

The Comparative Abilities of Propofol and Sevoflurane to Modulate Inflammation and Oxidative Stress in the Kidney After Aortic Cross-Clamping

Pilar Sánchez-Conde, MD^*, José M. Rodríguez-López, MD^*, Juan L. Nicolás, MBBS, Francisco S. Lozano, MD, Francisco J. García-Criado, MD, Carlos Cascajo, MD, Rogelio González-Sarmiento, MD, and Clemente Muriel, MD^*

From the *Department of Anesthesiology, University Hospital of Salamanca, Salamanca, Spain; Department of Anesthesiology, Rodríguez-Chamorro Hospital, Zamora, Spain; Departments of Surgery, and Medicine, University Hospital of Salamanca, Salamanca, Spain.

Address correspondence and reprint requests to José María Rodríguez-López, MD, Servicio de Anestesiología, Hospital Universitario de Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain. Address e-mail to jmrodlop{at}terra.es.

Abstract

BACKGROUND: Propofol has been reported to provide protection against ischemia–reperfusion injury. Nuclear transcription factor kappa B (NFB) plays a key role in oxidative stress and the inflammatory response during ischemia–reperfusion. We compared the effect of propofol with sevoflurane on kidney NFB expression and systemic inflammatory responses induced by aortic clamping.

METHODS: Twenty piglets were divided into four groups: sham surgery group with propofol (group SP, n = 5); sham group with sevoflurane (group SS, n = 5); and suprarenal clamping for 30 min with aorta–aortic bypass under propofol (group CP, n = 5) or sevoflurane (group CS, n = 5) anesthesia. Propofol was administered at 4 mg · kg^–1 · h^–1 IV and sevoflurane given at 1.5% inspiratory concentration. Peripheral blood and kidney biopsies were taken before the start of surgery, 15 min after unclamping the aorta, 24, 48, 72 h, and 7 days after surgery. Plasma creatinine, myeloperoxidase, tumor necrosis factor-, interleukin 1-β; and kidney superoxide anion and superoxidase dismutase were measured. The expression of inducible nitric oxide synthase and renal tissue NFB was measured using Western blotting.

RESULTS: Compared with the CS group, animals in the CP group had lower concentrations of myeloperoxidase, tumor necrosis factor-, interleukin 1β, superoxide anion, superoxidase dismutase (P < 0.05) from 24 to 72 h after surgery and diminished NFB expression and inducible nitric oxide synthase activity (P < 0.05) at 48 and 72 h after surgery, respectively.

CONCLUSIONS: Compared with sevoflurane, propofol administration during suprarenal aortic clamping and unclamping led to modulation of markers of inflammation and decreased NFB expression.

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