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.

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.