Investigation of the effects of anesthetic inhalation agents with certain biochemical and hematological parameters

Yıl 2025, Cilt: 6 Sayı: 1, 20 - 33, 30.06.2025

Fatma Arı , Egemen Dere

Öz

In this study, the effects of sevoflurane, desflurane and isoflurane on the personnel working in 4 different hospitals were investigated with some biochemical and hematological parameters. A total of 60 anesthesia technicians working in 42 operating rooms were divided into 3 experimental periods, 6-10, 11-15 and 16-20 years, depending on the duration of exposure to the anesthetic agent. 60 individuals with different professions, in the same age range as the experimental group, were selected as the control group. In blood samples, ALT, AST, ALP, CK, LDH, GST and amylase activities and Na+, K+, CK-MB, glucose, urea, total protein, total bilirubin, total cholesterol, triglyceride, leukocyte, erythrocyte and platelet amounts were measured.
Although values outside the normal limits were occasionally observed in the 120 individuals studied, the average of all parameters measured for 1 year was found to be within normal values in both the control and experimental groups. Only the enzymes we studied, AST and LDH in women and ALT in men, showed significant results compared to the control group, while Na and K were found to be significant in men (p<0.05).

Anahtar Kelimeler

Desflurane , enzyme , isoflurane , sevoflurane , sodium , potassium

Kaynakça

• [1] Seger C., Cannesson M. Recent advances in the technology of anesthesia F1000Research, 18:9:F1000 Faculty Rev-375(1), (2020). doi:10.12688/f1000research.24059.1
• [2] Kiani F., Jorfi S., Soltani F., Ghanbari S., Rezaee R., Mohammadi M.J. Exposure to anesthetic gases in the operating rooms and assessment of non-carcinogenic risk among health care workers. Toxicology Reports 11:1-8, (2023). doi:10.1016/j.toxrep.2023.06.007
• [3] Köner Ö. Anesthetic gases do harm to the environment, Is it time for a change? Turk Journal Anaesthesiology and Reanimation. 50:1 6–7, (2022). doi:10.5152/TJAR.2022.7222
• [4] Andersen M.P.S., Nielsen O.J., Wallington T.J., Karpichev B., Sander S.P. Assessing the impact on global climate from general anesthetic gases. Anesthesia & Analgesia, 114:5 1081-1085, (2012). doi:10.1213/ANE.0b013e31824d6150
• [5] Andemeskel Y., Elsholz T., Gebreyohannes G. Undesirable postoperative anesthesia outcomes at two national referral hospitals: A cross-sectional study in eritrea Anesthesiology Research and Practice, 9 1-8, (2020). doi:10.1155/2020/9792170
• [6] Panditrao M.M., Panditrao M.M. Anaesthesia and genetics: still, the uncharted territories. Journal of Anesthesia & Critical Care: Open Access. 4:1 16-19, (2016). doi: 10.15406/jaccoa.2016.04.00123
• [7] NIOSH. Waste anesthetic gases-occupational hazards in hospitals. National Institue for Occupational Safety and Healthy 151 1-9, (2007).
• [8] Brioni J.D., Varughese S., Ahmed R., Bein B. A clinical review of inhalation anesthesia with sevoflurane: from early research to emerging topics. Journal of Anesthesia. 31:5 764-778, (2017). doi:10.1007/s00540-017-2375-6
• [9] Aslan E., Gönen C., Saltürk A., Güzelbulut F. Hepatotoxicity after desflurane anesthesia. Haydarpasa Numune Medical Journal. 58:4 224-226, (2018). doi:10.14744/hnhj.2018.44265
• [10] Habig W.H., Pabst M.J., Jakoby W.B. Glutathione S-transferases. Journal of Biological Chemistry. 249:22 7130-7139, 1974.
• [11] Shozo S., Yoshitami K., Teruko S., Junko M., Takeshi T., Nozomu Y. The effects of sevoflurane anesthesia on insulin secretion and glucose metabolism in pigs. Anesthesia & Analgesia 84:6 1359-1365,1997. doi:10.1097/00000539-199706000-00034
• [12] Weiskopf R.B., Eger E.I., Ionescu P., Yasuda N., Cahalan M.K., Freire B., Peterson N., Lockhart S.H., Rampil I.J., Laster M. Desflurane does not produce hepatic or renal injure in human volunteers. Anesthesia & Analgesia. 74:4 570-576, 1992. doi:10.1213/00000539-199204000-00018.
• [13] Fanga X., Xiaa T., Xua F., Wua H., Maa Z., Zhaoa X., Gua X. Isoflurane aggravates peripheral and central insulin resistance in high-fat diet/streptozocin-induced type 2 diabetic mice. Brain research 1727, 2020. doi:10.1016/j.brainres.2019.146511
• [14] Özdemir H., Kaymak Ç., Kılınç A.Ş., Uncugil F., Takmaz S.A., Karabıyık L., Dikmen B. The assessment of stress response under desflurane and sevoflurane anesthesia. Turkiye Klinikleri Journal of Anesthesiology Reanimation. 451-457, 2006
• [15] Gil A.G., Silvan G., Illera J.C. Pituitary-adrenocortical axis, serum serotonin and biochemical response after halothane or isoflurane anesthesia in rabbits. Labaratory Animals. 41:4 411-419, 2007. doi:10.1258/002367707782314274
• [16] Kharasch E.D., Frink E.J., Artru A., Michasowski P., Rooke G.A., Nogami W.N. Long duration low-flow sevoflurane and isoflurane effect on postoperative renal and hepatic function. Anesthesia & Analgesia. 93:6 1511-1520, 2006. doi:10.1097/00000539-200112000-00036.
• [17] Soliman R., Yacoub A., Abdellatif M. Comparative effect of desflurane and sevoflurane on liver function tests of patients with impaired hepatic function undergoing cholecystectomy: A randomized clinical study. Indian Journal Anaesthesia. 64:5 383–390, 2020. doi:10.4103/ija.IJA_168_20
• [18] Topal A., Gül N., İlçöz Y., Görgül O.S. Hepatic effects of halothane, isoflurane or sevoflurane anesthesia in dogs. Journal of veterinary medicine. A, Physiology, pathology, clinical medicine. 50:10 530-533, 2003. doi: 10.1111/j.1439-0442.2004.00589.x.
• [19] Türkan H., Ayfın A., Sayal A. Effect of volatil anesthetics on oxidative stress due to occupational exposure. World Journal of Surgery. 29:4 540-542, 2005. doi: 10.1007/s00268-004-7658-z.
• [20] Karakıcık A.Z., Hayat A., Zerin M., Cay M. Effect of intraperitoneally injected selenium and vitamin E in rats anesthetized with halothane. Journal of Trace Elements in Medicine and Biology. 17 33-38, 2003. doi:10.1016/S0946-672X(03)80043-3.
• [21] Dikmen B., Ünal Y., Pampal H.K., Nurlu N., Kurtipek O., Canpolat O., Ozoğul C., Kavutcu M. Effects of repeated desflurane and sevoflurane anesthesia on enzymatic free radical scavanger system Molecular and Cellular Biochemistry. 294:1-2 31-36, 2007. doi:10.1007/s11010-006-9207-6. Epub 2006 Nov 29.
• [22] Sondergen E., Cederberg J., Vessby B., Baus S. Vitamin E reduced lipid peroxidation in experimental hepatotoxicity in rats. European Journal of Nutrition. 40:1 10-16, 2001. doi:10.1007/pl00007381.
• [23] Özer A.B., Özer S. 2007. The effect of likopen on histopatological changes in rats induced by sevoflurane. Fırat Üniversitesi Sağlık Bilimleri Tıp dergisi. 21:3 103-108, 2007.
• [24] Oladimeji M.A., Desalu I., Adekola O.O., Akanmu O., Adesida A.A. A Comparison of the Effect of Isoflurane and Propofol on Liver Enzymes. Journal of West African College of Surgeons. 12:2 28–33, 2022. doi:10.4103/jwas.jwas_69_22.
• [25] Işık B., Pamukcu Z., Alagöz A., The effect of sevoflurane and isoflurane on cognitive functions in early post-operative period. Inönü University Magazine of faculty of Medicine. 14:5 149-155, 2007.
• [26] Hemmerling T., Prietio M.D.I., Basık F., Noiseux N. Desflurane causes more atrial fibrillation and tachycardia after off-pump aorta-coronary bypass grafting (OPCAB) than sevoflurane. Canadian Journal of Anesthesia. 53:1 26414, 2006. doi:10.1007/BF03017017
• [27] Cromheeck S., Broecke P.W., Hendrickx E., Meeus R., Hert S.G. Incidence of atrial fibrillation early after cardiac surgery: Can choice of the anesthetic regimen influence the incidence? Acta Anaesthesiologica Belgica. 56:2 147-154, 2005.
• [28] De Ruijter, W., Musters R.J.P., Boer C., Steinen G.J.M., Simonides W.S., de Lange J.J. The cardioprotective effect of sevofluranee depends on protein kinase C activation, opening of mitochondrial K(+)ATP channels, and the production of reactive oxygen species. Anesthesia & Analgesia. 97:5 1370-1376, 2003. doi:10.1213/01.ANE.0000081786.74722.DA.
• [29] Franks N.P., Lieb W.R. Molecular and cellular mechanism of general anesthesia. Nature. 367 607-614, 1994. doi:10.1038/367607a0.
• [30] Boscan P., Watson Z., Steffey E.P. Plasma colloid osmotic pressure and total protein trends in horses during anesthesia. Veterinary Anesthesia Analgesia. 34:4 275-283, 2007. doi:10.1111/j.1467-2995.2006.00326.x.
• [31] Wissing H., Kuhn I. The effect of desflurane on liver function markers in infants and children. Acta Anaesth Scandinavica. 44 1149-1153, 2000. doi:10.1034/j.1399-6576.2000.440920.x
• [32] Horn N.A., Rossi L. Sevofluranee inhibits unstimulated and agonist. Induced platelet antigen expression and platelet function in whole blood in vitro. Anesthesiology. 95 1220-1225, 2001. doi:10.1097/00000542-200111000-00028
• [33] Türkan H., Beyan L., Karabıyık L., Güner D., Kaptan K. The effects of desflurane on human platelet aggregation in vitro. International Journal of Hematology. 80:1 91-93, 2004. doi:10.1532/ijh97.e0309.
• [34] Yerer M.B., Aydogan S., Comu F.M., Gender-related alerations in erythrocyte mechanical activities under desflurane or sevoflurane anesthesia. Clinical Hemorheology Microcirculation. 39:1-4 423-427, 2008. doi.org10.3233/CH-2008-1113
• [35] Coppens M.J., Versichelen .LF.M., Rolly G., Mortier E.P., Struys M.M. The mechanisms of carbon monoxide production by inhalation agents. Anesthesiology. 61:5 462-468, 2006. doi:10.1111/j.1365-2044.2006.04536.x.
• [36] Rosenberg P.H., Varitinnen H. Occupational hazards to reproduction and health in anaesthetics and paediatricians. Acta Anaesthesiologica Scandinavica. 22:3 202-207, 1978. doi:10.1111/aas.1978.22.3.202
• [37] Khan K.S., Hayes I., Buggy D.J. Pharmacology of anaesthetic agents II: Inhalation anaesthetic agents. Continuing Education in Anaesthesia Critical Care & Pain, 14:3 106-111, 2013. doi:10.1093/bjaceaccp/mkt038
• [38] Nair A.S. Pharmacogenomics of inhalational anesthetic agents. Medical Gas Research. 9:1 52–53, 2019. doi: 10.4103/2045-9912.254641
• [39] Sezen G., Demiraran Y., Kocaman A.B., Aksoy A. Subanestezik konsantrasyonlarda solutulan desfluran ve sevofluranın sıçanlarda karaciğer ve böbrek toksisitesi ile davranışları üzerine etkileri. Türk Anestezi ve Reanimasyon Dergisi. 35:2 83-89, 2007.
• [40] Miarta A., Lestari M.I., Zulkifli. Waste anesthetic gase: A forgotten problem. Journal Anesthesiology and Clinical Research. 1 15-25, 2020. doi.org/10.37275/jacr.v1i1.134