A Comparison of the Effects of Desflurane and TIVA on Antioxidant System in Morbidly Obese Patients
Condition: Oxidative Stress; Morbid Obesity
MeSH terms: Obesity, Morbid
Study type: Interventional

Summary: 
      With the development of technology, the safety of anesthesia devices and the progression of
      monitoring techniques affect the anesthetic management. There are some disadvantages such as
      high cost of inhalation anesthetics and long postoperative recovery time. The effects of
      total intravenous anesthesia (TIVA), which has been used for many years and whose positive
      aspects are well known, on antioxidant system in high risk patients such as morbid obese
      should be investigated. The aim of this study was to compare the effects of desflurane
      anesthesia and total intravenous anesthesia (TIVA) on the antioxidant system in morbidly
      obese patients undergoing bariatric surgery.
    

Detailed description: 
      Obesity is a chronic disease that negatively affects the quality and duration of life. It is
      one of the most important health problem in the world and very common in Turkey. Morbid
      obesity operations have started to be performed frequently in our country with the effective
      results obtained with the continuation of weight loss after being widely applied in Europe
      and the United States. In our country, with the increase of obesity, laparoscopic bariatric
      is preferred especially with low complication rates.

      Inhalation anesthesia is still a major source of chemical hazard in the hospital environment
      due to the widespread use in operating rooms. Factors affecting the presence of anesthetic
      gases in the environment; device leakage, ventilation, fresh gas flow and operation of the
      air wasting system. Long-term exposure to anesthetic gases is known to adversely affect the
      health of the workers in the operating room.

      It has been shown that many anesthetic agents produce free radicals and alter serum
      antioxidant levels in patients. Antioxidant enzymes clean free radicals. Free radicals
      induced by various diseases can trigger oxidative stress and result in increased oxidative
      products. It was reported that particularly desflurane induced oxidative stress and increased
      oxidative products. At the same time, it was reported that desflurane triggered local and
      systemic oxidative stress in the experimental studies, but propofol had antioxidant
      properties.

      With the development of technology, the safety of anesthesia devices and the progression of
      monitoring techniques affect the anesthetic management. There are some disadvantages such as
      high cost of inhalation anesthetics and long postoperative recovery time. The effects of
      total intravenous anesthesia (TIVA), which has been used for many years and whose positive
      aspects are well known, on antioxidant system in high risk patients such as morbid obese
      should be investigated. The aim of this study was to compare the effects of desflurane
      anesthesia and total intravenous anesthesia (TIVA) on the antioxidant system in morbidly
      obese patients undergoing bariatric surgery.
    

Intervention name(s): Total Antioxidant Status; Total Oxidant Status; Bispectral Index; Invasive arterial monitorization
Intervention type(s): Diagnostic Test; Diagnostic Test; Device; Other
Intervention description(s): Total Antioxidant Status values will be determined using a novel automated measurement method. The colour intensity, which can be measured spectrophotometrically, is related to the total amount of oxidant molecules present in the sample. The assay is calibrated with hydrogen peroxide) and the results are expressed in terms of micromolar hydrogen peroxide equivalent per litre.; Total Oxidant Status values will be determined using a novel automated measurement method. The colour intensity, which can be measured spectrophotometrically, is related to the total amount of oxidant molecules present in the sample. The assay is calibrated with hydrogen peroxide) and the results are expressed in terms of micromolar hydrogen peroxide equivalent per litre.; Bispectral Index is a method for depth of anesthesia and assessment of sedation. The values of bispectral index decreases with the deepening of anesthesia. The values of 40-60 characterize the appropriate depth of anesthesia.; Invasive arterial monitorization will be performed to right radial artery under local anesthesia to follow up hemodynamic changes and take the blood samples.
Intervention MeSH terms: Antioxidants
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Prospective Randomized Clinical Study
Masking: None (Open Label)
Primary purpose: Screening
Keywords: General anesthesia; Inhalation anesthetics; Total Intravenous anesthesia; Oxidative Stress; Morbid Obesity