Anesthetic propofol enhances plasma y-tocopherol levels in patients undergoing cardiac surgery

Abstract

Background: Propqfol (2,6-diisopropylphenol) is an anes-thetic drug with antioxidant and antiinflammatory properties, documented both in vitro and In experimental models of isch-emia-reperfusion Injury and septic shock. These properties have been related to the similarity of Its chemical structure to that of endogenous tocopherols, which are phenol-containing radical scavengers. This study evaluated the effects of propofol on a- and y-tocopherol (α- and y-T) levels and on selected markers of oxidant-antioxidant and Inflammatory status In patients undergoing cardiac surgery. Methods: Patients were randomly assigned for anesthesia with either propofo1 (propofo1 group, n = 22) or sevoflurane (control group, n = 21). Plasma levels of α- and y-T, Individual antioxidant capacity, malondlaldehyde, and interleukin 10 were measured before, during, and after anesthesia. In addition, levels of the proinflammatory prostaglandin E2 as a marker of cyclooxygen-ase-2 activity and those of interleukln 10 were measured In whole blood cultured with bacterial lipopolysaccharide. Results: y-T levels Increased significantly during surgery In propofol group (P < 0.0001 vs. control group). By contrast, α-T similarly decreased In both groups. Malondialdehyde and inter-leukln 10 increased markedly and individual antioxidant capac-ity decreased, without differences between groups. Prostaglan-din E2 levels measured 24 h after anesthesia Induction were significantly lower In the propofol than In the control group. In vitro studies highlighted the different capacity of y- and α-T to Impair prostaglandin E2 synthesis by human monocytes chal-lenged with bacterial lipopolysaccharide. The antiinflammatory properties of propofo1 that may be linked to its effect on y-T levels could be relevant In controlling the inflammatory response that accompanies tissue injury during reperfusion. Copyright © 2008, the American Society of Anesthesiologists, Inc.