Comparison of the effects of sevoflurane and propofol on lower extremity acute ischemia-reperfusion damage in rabbits

During reperfusion of ischemic tissues, free oxygen radicals and DNA injury develop. The genotoxic effect of sevoflurane and antioxidant effect of propofol are known. In this study, the effects of sevoflurane and propofol on free oxygen radicals and DNA injury that from as a result of ischemia-reperfusion of the lower extremities were investigated. Fourteen New Zealand Albino rabbits were randomly divided into two groups. The animals in one group (Group S) inhaled 2.5% - 4% sevoflurane using a mask, and the animals in the other group (Group P) were infused 1-2 mg/kg/dk propofol. Pneumatic tourniquet was placed on the lower extremity. The heart beat rate, invasive blood pressure, peripheric oxygen saturation, and anesthesia depth were monitored. Blood samples were obtained before the tourniquet application (control), 120 min. after the tourniquet application, and 15 min. and 120 min. after the tourniquet was removed. MDA levels, lipid preoxidation, tail moment, tail length, and tail intensity were determined to evaluate the DNA injury. Fifteen minutes after the tourniquet was removed, the mean MDA level of Group P was higher (8.15±2.61 ?M) than those of the controls (6.26±3.19 ?M) and Group S (4.98±0.77 ?M) (p<0.05). Although the increase of DNA injury was similar in both groups, this effect was more marked in the propofol group during the early reperfusion period (tail moment 1.05±0.45; tail intensity 5.33±1.56; p<0.05). These increases in the tail moment and tail intensity were normalized in both groups 2 hours after the turnpike was removed. Two hours after the tourniquet was removed, the increase in the MDA level of Group S and the increase in the tail moment and tail intensity were found to be correlated (Tail moment: r=832; p=0.020; Tail intensity: r=817, p=0.025). The oxidative stress and genotoxic effect determined in this study are reversible; thus, sevoflurane and propofol used in anesthesia for extremity surgery that leads to ischemia reperfusion were not found to be superior to each other.