Comparison of the Effects of Isoflurane and Propofol as Anesthesia Maintenance on Plasma Mitochondrial DNA Levels in Posterior Spinal Fusion Surgeries

Abstract

Background: Tissue injury resulting from surgical procedures leads to the release of various inflammatory agents, such as mitochondrial DNA (mt-DNA). This can trigger inflammatory mechanisms that may harm different organs. Objectives: In this study, we investigated the effects of isoflurane and propofol on mt-DNA levels during posterior spinal fusion (PSF) surgery. Methods: After meeting the inclusion criteria, 40 patients scheduled for PSF surgery were enrolled in a prospective randomized controlled clinical trial and randomly divided into groups receiving propofol or isoflurane for maintenance of anesthesia. Mitochondrial DNA levels were measured before surgery, one hour after induction of anesthesia, in the recovery unit, and 24 hours post-surgery. Results: There was no statistically significant difference between groups regarding age, gender, and mt-DNA levels prior to surgery (P-value > 0.05). However, mt-DNA levels were significantly higher in the isoflurane group one hour after induction of anesthesia (P-value = 0.001), in the recovery unit (P-value = 0.042), and 24 hours after surgery (P-value = 0.018). Conclusions: Propofol was superior to isoflurane, as demonstrated by a lesser elevation in plasma levels of mt-DNA in PSF patients.