Potent antioxidative potential of propofol during cardiopulmonary bypass in the adult

Abstract

The potent antioxidative potential of propofol during cardiopulmonary bypass (CPB) in adults was investigated. The selected 30 patients receiving open heart surgery under CPB were randomly divided into group A and group B. The patients in the group A and group B were given propofol (0. 1 mg. kg⁻¹, min⁻¹ and fentanyl (5 μg. kg⁻¹, min⁻¹) respectively to maintain anesthesia after aorta was cross-clamped. Blood samples were drawn pre-anesthesia, pre-CPB, at 30 min of CPB, at the end of CPB, at 1 h after CPB, at the end of operation, at 12 and 24 h postoperatively. RBC suspension was prepared and erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) and phosphofructokinase (PFK) activities, total erythrocyte reduced glutathione (GSH) and oxidized GSH (GSSG) were assayed and GSH/GSSG ratio was calculated. In the group A, G-6-PD and PFK activities and GSH/GSSG ratio were almost uneventfully during CPB and postoperatively. In the group B, G-6-PD activity was increased and PFK activity and GSH/GSSG ratio decreased significantly from 30 min of CPB until 12 h postoperatively. It was demonstrated that propofol could obviously attenuate free radical activity during CPB, while fentanyl has no effect on free radical reduction. Propofol could be beneficial as an anesthetic in patients presenting pathologies associated with free radical reactions during CPB.

Keywords

propofol / cardiopulmonary bypass / free radicals

References

[1] StewartJ R, BlackwellW H, CruteS L, et al. . Inhibition of surgically induced ischemia/reperfusion injury by oxygen free radical scavengers. J Thorac Cardiovasc Surg, 1983, 86262-262

[2] CavarocchiN C, EnglandM D, SchaffH V, et al. . Oxygen free radical generation during cardiopulmonary bypass: correlation with complement activation. Circulation, 1986, 74(III): 130-130

[3] NakayaH, TohseN, KannoM. Electrophysiological derangements induced by lipid peroxidation in cardiac tissue. Am J Physiol, 1987, 253H1089-H1089

[4] HessM L, MansonN H. Molecular oxygen: Friend and foe. The role of the oxygen free radical system in the calcium paradox, the oxygen paradox and ischemia/reperfusion injury. J Mol Cell Cardiol, 1984, 16969-969

[5] JosephsonR A, SilvermanH S, LakattaE G, et al. . Study of the mechanisms of hydrogen peroxide and hydroxyl free radical-induced cellular injury and calcium overload in cardiac myocytes. J Biol Chem, 1991, 2662354-2354

[6] WebsterN R, NunnJ F. Molecular structure of free radicals and their importance in biological reactions. Br J Anaesth, 1988, 6098-98

[7] NavapurkarV U, SkepperJ N, JonesJ G, et al. . Propofol preserves the viability of isolated rat hepatocyte suspensions under an oxidant stress. Anesth Analg, 1998, 871152-1152

[8] HrysonH M, FultonB R, FauldsD. Propofol: an update of its use in anaesthesia and conscious sedation. Drugs, 1995, 50513-513

[9] MurphyP G, MyersD S, DaviesM J, et al. . The antioxidant potential of propofol (2,6-diisopropylphenol). Br J Anaesth, 1992, 68613-613

[10] MurphyP G, DaviesM J, ColumbM O, et al. . Effect of propofol and thiopentone on free radical mediated oxidative stress of the erythrocyte. Br J Anaesth, 1996, 76536-536

[11] LohrG W, WallerH D. BergmeyerH U. Glucose-6-phosphoate dehydrogenase. Methods of Enzymatic Analysis, 19742end ed.Wuhan, Academic: 636-643

[12] BergmeyerH U, GawehnK, GrasslM. BergmeyerH U. Enzymes as biochemical reagents. Methods of. Enzymatic Analysis, 19742end ed.Wuhan, Academic: 424-522

[13] BarbagalloM, DominguezL J, TagliamonteM R, et al. . Effects of vitamin E and glutathione on glucose metabolism: role of magnesium. Hypertension, 1999, 341002-1002

[14] DaviesS W, DuffyJ P, WickensD G, et al. . Cardiopulmonary bypass, myocardial management, and support techniques: time-course of free radical activity during coronary artery operations with cardiopulmonary bypass. J Thorac Cardiovasc Surg, 1993, 105979-979

[15] SchraufstatterI U, HinsgawD B, HyslopP A, et al. . Glutathione cycle activity and pyridine nucleotide levels in oxidant-induced injury of cells. J Clin Invest, 1985, 761131-1131

[16] HansP, DebyC, Deby-DupontG, et al. . Effect of propofol on in vitro lipid peroxidation induced by different free radical generating systems: a comparison with vitamin E. J Neurosurg Anesthesiol, 1996, 8154-154

[17] KramerJ H, MakI T, WeglickiW B. Differential sensitivity of canine cardiac sarcolemmal and microsomal enzymes to inhibition by free radical-induced lipid peroxidation. Circ Res, 1984, 55120-120

[18] KanekoM, BeamishR E, DhallaN S. Depression of heart sarcolemmal Ca²⁺ pump activity by oxygen free radicals. Am J Physiol, 1989, 256H368-H368

[19] CorrettiM C, KoretsuneY, KusuokaH, et al. . Glycolytic inhibition and calcium overload as consequences of endogenously generated free radicals in rabbit hearts. J Clin Invest, 1991, 881014-1014

[20] CookD J, HousmansP R. Mechanism of the negative inotropic effect of propofol in isolated ferret ventricular myocardium. Anesthesiology, 1994, 80859-859

[21] GeenT R, BennettS R, NelsonV M. Specificity and properties of propofol as an antioxidant free radical scavenger. Toxicol Appl Pharmacol, 1994, 129163-163

[22] MurphyP G, BennettJ R, MeyersD S, et al. . The effect of propofol anesthesia on free radical-induced lipid peroxidation in rat liver microsomes. Eur J Anaesthesiol, 1993, 10261-261