Effect of Fresh Gas Flow Rate on Thiol/Disulphide Hemostasis and Ischemia-modified Albumin in Laparoscopic Cholecystectomy

Abstract

Objective: To investigate the effects of low-flow and high-flow anesthesia techniques, administered with sevoflurane during laparoscopic cholecystectomy, on thiol/disulphide homeostasis and serum ischemia-modified albumin (IMA) levels. Study Design: Double-blind, randomised study. Place and Duration of Study: Department of Anesthesiology and Reanimation, Health Science University, Bursa Yuksek Ihtisas Training and Education hospital, Bursa, Turkey from January to October 2020. Methodology: Patients over the age of 18 years, scheduled for elective laparoscopic cholecystectomy, were included in the study. The patients were divided into two groups: Group 1 (low-flow, 1 L/min) and Group 2 (high-flow, 2 L/min). The blood samples for thiol/disulphide homeostasis and serum IMA levels were collected as follows: 5 minutes before induction of anesthesia (T0), 5 minutes after induction of anesthesia (T1) and postoperative 24th hour (T2). Results: The final analysis included 104 patients. The two groups did not differ significantly in terms of any of the demographic characteristics (p >0.05). There were also no inter-group differences in terms of thiol/disulphide homeostasis parameters or serum IMA levels at T0, T1, or T2. However, in both groups, there were statistically significant changes in serum disulphide and IMA levels from T0 to T1 and T0 to T2 (p=0.000, and p=0.005, respectively). Conclusion: There was no difference between low-flow and high-flow anesthesia during laparoscopic cholecystectomy in terms of hemodynamics or thiol/disulphide homeostasis.