Propofol Effect on Stress Response and Free Radicals in Patient during Surgery and Sedation Procedure

Theresia Monica Rahardjo

Abstract


BACKGROUND: Propofol is an intravenous anesthetic used worldwide as an anesthesia induction and maintenance agent. Propofol also used as sedation agent in Intensive Care Unit (ICU). Despite it’s usual anesthesia properties, propofol has an unique pharmacologic characteristic, especially as antioxidant and stress response reduction. These advantages suggested propofol has positive effects when used as an anesthesia agent in surgery or sedation in ICU in conditions when high stress and free radical level are released.

CONTENT:Stress response and free radical can be elevated in various conditions including surgery or during care in ICU, especially critical ill patient. Cortisol is a major stress hormone that influences metabolism, cardiovascular and central nervous system, either in acute or chronic phase. Oxidative stress was marked by free radical elevation called Radical Oxygen Species (ROS). Combination of both elements (cortisol and ROS) can worsen patient condition. Propofol with anti-stress and antioxidant properties could be used to reduce stress response and attenuate free radical level in order to improve patient condition.

SUMMARY: The anti-stress and antioxidant properties of Propofol are interesting, because these benefits can be added as adjunctive therapy when propofol was used as an anesthetic agent in surgery and a sedation in ICU.

KEYWORDS: propofol, stress response, antioxidant


Full Text:

PDF

References


Kotani Y, Shimazawa M, Yashimura S, Iwama T, Hara H. The experimental and clinical pharmacology of propofol, an anesthetic agent with neuroprotective properties. CNS Neurosci Ther. 2008; 14: 95-106, CrossRef.

Kim KM, Choi BM, Park SW, Lee SH, Christensen LV, Zhou J, et al. Pharmacokinetics and pharmacodynamics of propofol microemulsion and lipid emulsion after an intravenous bolus and variable rate infusion. Anesthesiology. 2007; 5: 924-34, CrossRef.

Polley LS. Hypertensive disorder. In: Chestnut DH, Polley LS, Tsen LC, Wong CA, editors. Chestnut’s Obstetric Anesthesia Principles And Practice. 4th ed. Philadelphia: Mosby Elsevier; 2009. p.975-1007, CrossRef.

Dedovic K, Duschesne A, Andrews J, Engert V, Pruessner JC. The brain and the stress axis: The neural corelates of cortisol regulation in response to stress. Neuroimage. 2009; 47: 864-71, CrossRef.

Vianna P, Bauer ME, Dornfeld D, Chies JAB. Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol level and altering lymphocyte sensitivity to glucocorticoids. Med Hypotheses. 2011; 77: 188-91, CrossRef.

Kostopanagiotou G, Kalimeris K, Christodoulaki K, Nastos C, Papoutsidakis N, Dima C, et al. The differential impact of volatile and intravenous anaesthetics on stress response in the swine. Hormones. 2010; 9: 67-75, CrossRef.

Ihn CH, Joo CD, Choi JW, Kim DW, Jeon YS, Kim YS, et al. Comparison of stress hormone response, interleukin-6 and anaesthetic characteristics of two anaesthetic techniques: volatile induction and maintenance of anaesthesia using sevoflurane versus total intravenous anaesthesia using propofol and remifentanil. J Int Med Res. 2009; 37: 1760-71, CrossRef.

Azemati S, Savai M, Khosravi MB, Allahyari E, Jahanmiri F. Combination of remifentanil with isoflurane or propofol: effect on the surgical stress response. Acta Anaesth Belg. 2013; 64: 25-31, PMID.

De Cosmo G, Congedo E, Clemente A, Aceto P. Sedation in PACU: The role of propofol. Curr Drug Targets. 2005; 6: 741-4, CrossRef.

Aghdaii N, Yazdanian F, Faritus SZ. Sedative efficacy of propofol in patients intubated/ventilated after coronary artery bypass graft surgery. Anesth Pain Med. 2014; 4: e17109, CrossRef.

Rao GM, Sumita P, Roshni M, Ashtagimatt MN. Plasma antioxidant vitamins and lipid peroxidation products in pregnancy induced hypertension. Indian J of Clin Biochemistry. 2005; 20: 198-200, CrossRef.

Morad R, Masoomeh J. Evaluation of serum nitrite, nitrate and malondialdehyde concentrations in preeclampsia. J Reprod Infertil. 2010; 11: 105-12, article.

Sharma JB, Sharma A, Bahadur A, Vimala N, Satyam A, Mittal S. Oxidative stress markers and antioxidant levels in normal pregnancy and pre-eclampsia. Int J Gynecol Obstets. 2006; 94: 23-7, CrossRef.

Lee JY, Kim MC. Effect of propofol on oxidative stress status in erythrocyte from dogs under general anaesthesia. Acta Vet Scand. 2012; 54: 76-80, CrossRef.

Khatri M. Circulating biomarkers of oxidative stress in normal pregnancy and preeclampsia and efficacy of antioxidant supplementation. Int J Reprod Contracep Obstet Gynec. 2013; 2: 304-10, CrossRef.

Japan Institute For The Control Of Aging (JaICA) [homepage in the Internet]. Shizuoka: Anti-malondialdehyde (MDA) monoclonal antibody (clone 1F83) [cited 2013 Dec 29]. Available from: http://www.jaica.com/.

Liu YC, Chang AYW, Tsai YC, Chan JYH. Differential protection against oxidative stress and nitric oxide overproduction in cardiovascular and pulmonary system by propofol during endotoxemia. J Biomed Sci. 2009; 16: 1-14, CrossRef.

Aldemir O, Celebi H, Cevik C, Duzgun E. The effects of propofol or halothane on free radical production after tourniquet induced ischaemia-reperfusion injury during knee arthroplasty. Acta Anaesthesiology Scand. 2001; 45: 1221-5, CrossRef.

Sayin MM, Ozatamer O, Tasoz R, Kilinc K, Unal N. Propofol attenuates myocardial lipid peroxidation during coronary artery bypass grafting surgery. Br J Anaesth. 2002; 89: 242-6, CrossRef.

Zhang SH, Wang SY, Yao SL. Antioxidative effect of propofol during cardiopulmonary bypass in adult. Acta Pharmacol Sin. 2004; 25: 334-40, PMID.




DOI: https://doi.org/10.18585/inabj.v7i3.183

Indexed by:

                 

                  

               

     

 

The Prodia Education and Research Institute