The protective effect of insulin against isoflurane and sevoflurane induced hepatocellular apoptosis

الملخص EN

Several studies deducted that inhalational anesthetics induce apoptosis in human cells.

Insulin is believed to have an antiapoptotic action so it is widely used as cardioprotective agent against ischemic reperfusion injuries.

This study compared the apoptotic effect of inhalational anesthetics and figuring out the antiapoptotic effect of insulin against perioperative induced hepatocellular apoptosis using immune histochemical study of liver biopsy.

Eighty (ASA I) patients scheduled for laparoscopic cholecystectomy were randomly allocated into 4 groups (20 patients each).

Two groups were anesthetized using isoflurane and the other two were anesthetized using sevoflurane.

The control groups (IC, SC) received normal saline and the insulin groups (II, SI) received glucose, insulin and potassium (GIK) infusion.

Infusions were given 2 hours before induction of anesthesia.

Liver biopsy was taken before the umbilical port closure.

In liver biopsy Caspase 3, 7, 9 and Akt activity were evaluated.

Liver function tests were estimated before infusion and one day after surgery.

Serum K and blood glucose levels were closely monitored all through the study.

The results showed that in the isoflurane groups, the percentage of caspase 3 and 7 positive cases decreased while Akt positive cases increased significantly in II compared to IC respectively (p < 0.05).

In the sevoflurane groups, the percentage of caspase 3 positive cases decreased significantly in SI compared to SC group (p < 0.05).