Comparison of the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx

Comparison of the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx in Laparoscopic Hysterectomy Surgery

The glycocalyx is a dynamic and complex biochemical structure composed of proteoglycans, glycoproteins, and soluble proteins. The glycocalyx interacts with various proteins such as albumin and orosomucoid to form a thick surface layer on the vessel surface that is physiologically active. This is called the endothelial surface layer. This structure is constantly changing with the blood flowing in the vein. The glycocalyx regulates oncotic pressure and also prevents leukocyte and platelet adhesion to the endothelium. Endothelial cell dysfunction is a valuable marker of increased vascular permeability and impaired angiogenesis due to cardiovascular, thoracic, renal, and metabolic diseases.

Study Overview

• Status: Completed
• Conditions: Endothelial Dysfunction
• Intervention / Treatment: Diagnostic test: desflurane anesthesia; Diagnostic test: sevoflurane anesthesia

Detailed Description

The glycocalyx is a dynamic and complex biochemical structure composed of proteoglycans, glycoproteins, and soluble proteins. The glycocalyx interacts with various proteins such as albumin and orosomucoid to form a thick surface layer on the vessel surface that is physiologically active. This is called the endothelial surface layer. This structure is constantly changing with the blood flowing in the vein. The glycocalyx regulates oncotic pressure and also prevents leukocyte and platelet adhesion to the endothelium. Endothelial cell dysfunction is a valuable marker of increased vascular permeability and impaired angiogenesis due to cardiovascular, thoracic, renal, and metabolic diseases.

Some medical approaches, including anti-thrombin III, nitric oxide, the TNF-α analog etanercept, and inhalation agents, can repair or prevent deterioration of the endothelial glycocalyx. In a study by Chen et al., it was shown that Sevoflurane has a protective effect on syndecan and heparan sulfate, which are located in the glycocalyx structure, thus reducing leukocyte and platelet adhesion and protecting the vascular endothelium (8).

Kim et al. In a study conducted, it was shown that the protective effect of propofol, an intravenous anesthetic, on the vascular endothelium was greater than that of sevoflurane In our research, no study was found on the effect of another inhalation anesthetic, desflurane, on the vascular glycocalyx structure. In this study, we aimed to investigate and compare the effects of sevoflurane and desflurane on glycocalyx.

• Study Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• Turkey
  • Kartal
    • İstanbul, Kartal, Turkey, 34000
      • Tahsin Şimşek

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

healthy volunteers

Description

Inclusion Criteria:

• Be in the 18-65 age rang
• Being in the ASA 1-3 risk group
• patients receiving general anesthesia

Exclusion Criteria:

• refuse to participate in the study

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
desflurane; Anesthesia maintenance of the first group will be provided with desflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.	Diagnostic test: desflurane anesthesia; Anesthesia maintenance of the first group will be provided with desflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.
sevoflurane; Anesthesia maintenance of the first group will be provided with sevoflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.	Diagnostic test: sevoflurane anesthesia; Anesthesia maintenance of the first group will be provided with sevoflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
glycocalyx components	The primary aim of the study was to measure the levels of heparan sulfate and syndecan, which are markers of endothelial glycocalyx structure, after the use of desflurane or sevoflurane. High biomarker levels are associated with impaired glycocalyx structure	the study will comlete in one month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
haemodynamic changes	The secondary aim of the study is to compare the hemodynamic effects of sevoflurane and desflurane.	studdy will complete in one month

Collaborators and Investigators

• Sponsor: Kocaeli Derince Education and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): August 25, 2021
• Primary Completion (Actual): October 25, 2021
• Study Completion (Actual): November 4, 2021

Study Registration Dates

• First Submitted: August 20, 2021
• First Submitted That Met QC Criteria: October 2, 2021
• First Posted (Actual): October 5, 2021

Study Record Updates

• Last Update Posted (Actual): November 9, 2021
• Last Update Submitted That Met QC Criteria: November 6, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics, General; Platelet Aggregation Inhibitors; Anesthetics, Inhalation; Anesthetics; Desflurane; Sevoflurane
• Other Study ID Numbers: 514-192-32

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No