Investigation of the metabolomic effects of sevoflurane and desflurane in middle ear surgery

Aim: Metabolomics is a field that provides an understanding of cellular processes and the overall metabolic profile of the organism. The aim of this study was to investigate the changes in amino acid and carnitine metabolomic profiles induced by Sevoflurane and Desflurane anaesthesia on patients during middle ear surgery. Materials and Methods: Patients were divided into 2 groups according to the type of inhalation anaesthetic (Desflurane n=48, Sevoflurane n=48). Demographic data (age, gender, height, weight), type of surgery (tympanoplasty, mastoidectomy), time under general anaesthesia, durations of total operation and surgery, amount of anaesthetic agents used, haemodynamic data (arterial blood pressure, SpO2, pulse rate) were recorded. After induction of anaesthesia, the patients were oro-tracheally intubated and the first blood samples were taken before inhalation anaesthesia started. After the surgical procedure was completed and inhalation anaesthesia was terminated, second blood samples were taken. Free amino acid and carnitine profiles were determined by LC-MS/MS (Liquid Chromatography /Mass /Spectrometry) method and statistical analyses were performed. Results: When the demographic data of the patients (age, gender, height, weight) were compared, no significant difference was found between the groups (p>0.05). When the changes in the amino acid and carnitine profiles in the Sevoflurane and Desflurane groups were examined; no difference was found between the two groups in the amino acid and carnitine levels in the samples taken before inhalation anesthesia (p>0.05). When the levels in the first and second samples within the groups were compared, it was seen that there was a significant difference in 14 carnitine and 10 amino acid levels in the Sevoflurane group (p<0.05), and there was a significant difference in 23 carnitine and 10 amino acid levels in the Desflurane group (p<0.05). When the changes between the first and second samples of the 2 xii groups were compared, it was seen that tyrosine levels increased more significantly in the Sevoflurane group compared to the Desflurane group (p<0.05), and the decrease in C18:1 carnitine level was more significant in Desflurane than in Sevoflurane (p<0.05). Conclusion: In this study, when the metabolomic effects of Sevoflurane and Desflurane were examined, we found that more metabolomic parameters changed in the Desflurane group than in the Sevoflurane group, while carnitine and amino acid levels changed less in the Sevoflurane group. We think that our study will be a reference for future clinical studies in terms of understanding the metabolomic effects of inhalation anaesthetics in the body.