Abstract
General anesthesia can impair immunological defense mechanisms while inducing an inflammatory reaction. Generalized inflammatory reactions involve leucocytes which in turn release inflammatory mediators and free oxygen radicals. General anesthetics include a series of gaseous and intravenous sedative-hypnotic agents indicated for induction and maintenance of general anesthesia as well as for sedation of intubated, mechanically ventilated adults in intensive care units (ICU). Some anesthetics, such as propofol, are characterized by a phenolic structure similar to that of alpha-tocopherol, and exhibit antioxidant properties that have been demonstrated both in vitro and in vivo. Similarly, other anesthetics show antioxidant and protective roles but this mechanism is to be related to their ability to induce antioxidant enzyme (i.e., heme oxygenase-1). The aim of the present review is to evaluate the antioxidant properties of anesthetics in various experimental models and if they may be considered efficient therapeutic tools in counteracting oxidative stress during general anesthesia and sedation in ICU.
MeSH terms
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Adult
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Anesthetics, General / adverse effects
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Anesthetics, General / chemistry*
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Anesthetics, General / classification
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Anesthetics, General / pharmacology
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Antioxidants / pharmacology*
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Astrocytes / drug effects
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Cells, Cultured / drug effects
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Desflurane
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Enzyme Induction / drug effects
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Heme Oxygenase-1 / antagonists & inhibitors
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Heme Oxygenase-1 / biosynthesis
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Heme Oxygenase-1 / physiology
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Humans
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Hypnotics and Sedatives / chemistry
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Hypnotics and Sedatives / pharmacology
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Immune Tolerance / drug effects
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Inflammation / etiology
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Inflammation Mediators / metabolism
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Isoflurane / analogs & derivatives
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Isoflurane / chemistry
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Isoflurane / pharmacology
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Leukocytes / metabolism
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Molecular Structure
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Oxidation-Reduction
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Oxidative Stress / drug effects
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Propofol / chemistry
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Propofol / pharmacology
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Reactive Oxygen Species / metabolism
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Reperfusion Injury / prevention & control
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Volatile Organic Compounds / chemistry
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Volatile Organic Compounds / pharmacology
Substances
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Anesthetics, General
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Antioxidants
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Hypnotics and Sedatives
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Inflammation Mediators
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Reactive Oxygen Species
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Volatile Organic Compounds
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Desflurane
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Isoflurane
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HMOX1 protein, human
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Heme Oxygenase-1
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Propofol