None listed
Conditions
Brief summary
The hypothesis to be studied is that the commonly used inhaled anesthetics isoflurane and sevoflurane may induce apoptosis in liver and insulin can guard against their apoptotic effect. This study has two objectives: The first one is to compare the apoptotic effect of isoflurane and sevoflurane on human hepatocytes and the second objective is to figure out the rule of insulin infusion as antiapoptoic agent in modulation of such effect evidenced by immunohistochemical study of liver biopsy and blood markers. Pre and postoperative liver and kidney function tests will be measured to help correlating the apoptotic changes with biochemical changes if present.
Interventions
80 patients undergoing laporoscopic cholecystectomy will be divide into 2 groups. After induction of general anesthesia with propofol 1mg kg-1 , fentanyl 2 microg kg-1 and atracurium 0.5 mg kg-1 then anesthesia will be maintained by: Arm 1 will receive isoflurane inhalational anesthetic by the dose 1.2% (1MAC) and Arm 2 sevoflurane inhalational anesthetic by the dose 2% (1MAC) after induction for maintenance of general anesthesia till the end of surgery. The type of surgery is laporoscopic chol
80 patients undergoing laporoscopic cholecystectomy will be divide into 2 groups. After induction of general anesthesia with propofol 1mg kg-1 , fentanyl 2 microg kg-1 and atracurium 0.5 mg kg-1 then anesthesia will be maintained by: Arm 1 will receive isoflurane inhalational anesthetic by the dose 1.2% (1MAC) and Arm 2 sevoflurane inhalational anesthetic by the dose 2% (1MAC) after induction for maintenance of general anesthesia till the end of surgery. The type of surgery is laporoscopic cholecystectomy which lasts about one hour in our institute. Both inhalational anesthetic drugs will be monitored with infrared gas spectrophotometry to adjust the targeted end tidal concentration. Both arms will be subdivided into control subgroup which will receive 500 ml ringer acetate intravenous infusion 1 hour before surgery, and insulin subgroup which will receive glucose insulin potassium (GIK) intravenous infusion to study its protective effect against apoptosis. GIK is composed of 500 ml of 10% dextrose, 10 mEq of potassium and 10 IU of regular insulin. All fluids will be infused over 30 minutes and will be finished before starting the operation.
Sponsors
Theodor Bilharz Research Institute
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
25 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
Elective laporscopic cholecystectomy. Age: 25-55 years. Gender: Both male and female. BMI: 20-30 kg/m2 (Normal weight). ASA Class: I.
Exclusion criteria
Pregnancy and lactation. Fever or sepsis. Addicts and drug abusers. Acute cholecystitis.
Outcome results
None listed