Impact of low-flow desflurane versus sevoflurane anesthesia on thiol-disulfide homeostasis in adults undergoing elective thyroidectomy: a randomized controlled trial.

OBJECTIVE

Thiol-disulfide homeostasis is a marker of oxidative stress. The aim of the study was to compare the effects of low-flow desflurane and sevoflurane anesthesia on perioperative changes in thiol-disulfide balance in patients undergoing thyroidectomy.

METHODS

In this randomized controlled trial, 50 ASA I-II patients were assigned to receive low-flow desflurane (n=25) or sevoflurane (n=25). Blood samples were collected before and after surgery. The primary outcomes were between-group comparisons of perioperative changes in total and native thiol levels. Secondary outcomes included changes in disulfide concentrations and thiol-disulfide ratios.

RESULTS

For the primary outcomes, the magnitude of reduction in total thiol (86.4±159.7 vs. 151.5±104.9 μmol/L; p=0.095) and native thiol (79.3±130.1 vs. 115.1±86.3 μmol/L; p=0.257) did not differ significantly between the desflurane and sevoflurane groups. For the secondary outcomes, disulfide levels significantly decreased in the sevoflurane group (67.5±19.9 vs. 48.4±18.1 μmol/L; p=0.001), whereas no significant change was observed in the desflurane group (60.2±23.2 vs. 52.5±34.5 μmol/L; p=0.300). Between-group comparisons of disulfide/total thiol, native thiol/total thiol, and disulfide/native thiol ratios revealed no significant differences.

CONCLUSION

Low-flow desflurane and sevoflurane anesthesia demonstrated similar effects on perioperative thiol-disulfide homeostasis in thyroidectomy patients.