{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:26:22Z","timestamp":1785425182905,"version":"3.56.0"},"reference-count":41,"publisher":"Centre for Evaluation in Education and Science (CEON\/CEES)","issue":"5","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/BY\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Biochemistry"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>Background: Laparoscopic appendectomy offers several advantages over open surgery, including shorter recovery time and less postoperative pain. However, it also poses some risks due to the creation of pneumoperitoneum. Understanding and mitigating this risk through the use of appropriate anaesthetic agents, antioxidant therapy, and optimised surgical techniques can improve patient outcomes. This study aimed to determine which of the two anaesthetics, propofol or sevoflurane, provides better suppression of oxidative, inflammatory and metabolic responses in children undergoing laparoscopic or conventional appendectomy. Methods: This randomised, clinical control trial enrolled 120 children aged 7 to 17 years with a diagnosis of acute appendicitis. Key parameters, including blood glucose, white blood cells, IL-6, oxidative stress markers, lactate, pH, and mean arterial pressure, were analysed. Results: A statistically significant change in lactate and mean arterial pressure values was observed over time in all four study groups. However, neither the type of surgical procedure nor the type of anaesthesia significantly influenced glucose, white blood cells or thiobarbituric acid levels. The postoperative values of IL-6 were lower in patients treated with balanced anaesthesia. Conclusions: Our study demonstrated that the type of anaesthesia affects hemodynamic changes, which are closely related to the occurrence of reperfusion injury. Although markers of tissue hypoxia and acidosis were elevated during laparoscopic surgery, their values quickly normalised in the immediate postoperative period.<\/jats:p>","DOI":"10.5937\/jomb0-56035","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T05:41:41Z","timestamp":1743486101000},"page":"1110-1117","source":"Crossref","is-referenced-by-count":0,"title":["Effects of propofol and sevoflurane on metabolic changes and oxidative stress markers in laparoscopic appendectomy in children: Clinical control trial"],"prefix":"10.5937","volume":"44","author":[{"suffix":"Izabella","given":"Galambos","family":"Fabri","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0100-4105","authenticated-orcid":false,"given":"Biljana","family":"Dra\u0161kovi\u0107","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0821-0825","authenticated-orcid":false,"given":"Marina","family":"Pandurov","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5974-4002","authenticated-orcid":false,"given":"Goran","family":"Raki\u0107","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0103-3029","authenticated-orcid":false,"given":"Nikola","family":"Bo\u0161kovi\u0107","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2153-3135","authenticated-orcid":false,"given":"Sanja","family":"Vickovi\u0107","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragana","family":"Pap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2815-017X","authenticated-orcid":false,"given":"Anna","family":"Uram-Benka","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00xa57a59","id-type":"ROR","asserted-by":"publisher"}]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3964","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Baxter KJ, Short HL, Travers CD, Heiss KF Raval MV Implementing a surgeon-reported categorisation of pediatric appendicitis severity. Pediatr Surg Int 2018; 34(12): 1281-6;","DOI":"10.1007\/s00383-018-4364-8"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Cameron DB, Anandalwar SP Graham DA, Melvin P Serres SK, Dunlap JL, Kashtan M, Hall M, Saito JM, Barnhart DC, Kenney BD, Rangel SJ. Development and Implications of an Evidence-based and Public Health-relevant Definition of Complicated Appendicitis in Children. Ann Surg 2020; 271(5): 962-8;","DOI":"10.1097\/SLA.0000000000003059"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Zani A, Hall NJ, Rahman A, Morini F, Pini Prato A, Friedmacher F Koivusalo A, van Heurn E, Pierro A. European Paediatric Surgeons' Association Survey on the Management of Pediatric Appendicitis. Eur J Pediatr Surg 2019; 29(1): 53-61;","DOI":"10.1055\/s-0038-1668139"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Lee-Ong A. Physiologic Considerations in Laparoscopic Surgery. In: Lomanto D, Chen WTL, Fuentes MB, editors. Mastering Endo-Laparoscopic and Thoracoscopic Surgery. Springer, Singapore; 2023: 83-5;","DOI":"10.1007\/978-981-19-3755-2_13"},{"key":"ref5","unstructured":"Veekash G, Wei LX, Su M. Carbon dioxide pneumoperitoneum, physiologic changes and anesthetic concerns. Ambul Surg 2010; 16(2): 41-6;"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Arsalani-Zadeh R, Ullah S, Khan S, MacFie J. Oxidative stress in laparoscopic versus open abdominal surgery: a systematic review. J Surg Res 2011; 169(1): e59-68;","DOI":"10.1016\/j.jss.2011.01.038"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Mi Xiang, Yingdong Lu, Laiyun Xin, Jialiang Gao, Chang Shang, Zhilin Jiang, Hongchen Lin, Xuqin Fang, Yi Qu, Yuling Wang, Zihuan Shen, Mingjing Zhao, Xiangning Cui. Role of Oxidative Stress in Reperfusion following Myocardial Ischemia and Its Treatments. Oxid Med Cell Longev 2021; (2021): 6614009;","DOI":"10.1155\/2021\/6614009"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Gong J-S, Yao, YT, Fang N-X, Li L-H. Sevoflurane postconditioning attenuates reperfusion-induced ventricular arrhythmias in isolated rat hearts exposed to ischemia\/reperfusion injury. Mol Biol Rep 2012; 39(6): 6417-25;","DOI":"10.1007\/s11033-012-1447-9"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Xu Z, Qian B. Sevoflurane anesthesia-mediated oxidative stress and cognitive impairment in hippocampal neurons of old rats can be ameliorated by expression of brain derived neurotrophic factor. Neurosci Lett 2020; 721: 134785;","DOI":"10.1016\/j.neulet.2020.134785"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Lee YM , Song BC, Yeum KJ. Impact of Volatile Anesthetics on Oxidative Stress and Inflammation. Biomed Res Int 2015; 242709;","DOI":"10.1155\/2015\/242709"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Haraldsen P Cunha-Goncalves D, Metzsch C, Algotsson L, Lindstedt S, Ingemansson R. Sevoflurane provides better haemodynamic stability than propofol during right ventricular ischaemia-reperfusion. Interact Cardiovasc Thorac Surg 2020; 30(1): 129-35;","DOI":"10.1093\/icvts\/ivz235"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Yu W, Gao D, Jin W, Liu S, Qi S. Propofol Prevents Oxidative Stress by Decreasing the Ischemic Accumulation of Succinate in Focal Cerebral Ischemia-Reperfusion Injury. Neurochem Res 2018; 43(2): 420-9;","DOI":"10.1007\/s11064-017-2437-z"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Yiannakopoulou E, Nikiteas N, Perrea D, Tsigris C. Pharmacological modulation of oxidative stress response in minimally invasive surgery: systematic review. Surg Laparosc Endosc Percutan Tech 2012; 22(3): 200-4;","DOI":"10.1097\/SLE.0b013e318247d15e"},{"key":"ref14","unstructured":"Colak E, Pap D, Nikoli\u0107 L, Vickovi\u0107 S. The impact of obesity to antioxidant defense parameters in adolescents with increased cardiovascular risk. J Med Biochem 2020; 39(3): 346-54;"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Zhong X , Niu Q, Yuan X . Predictive value of inflammatory factors on the efficacy of adjuvant Dexamethasone in the treatment of refractory purulent meningitis among pediatric patients. J Med Biochem 2024; 43(4): 406-12;","DOI":"10.5937\/jomb0-37618"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Almagor M, Mintz A, Sibirsky O, Durst A. Preoperative and postoperative levels of interleukin-6 in patients with acute appendicitis: comparison between open and laparoscopic appendectomy. Surg Endosc 2005; 19(3): 331-3;","DOI":"10.1007\/s00464-003-9311-6"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Smith I, Kranke, Murat I, Smith A, O'Sullivan G, Soreide E, Spies C, in't Veld B. Perioperative fasting in adults and children guidelines from the European Society of Anaesthesiology. European Journal of Anaesthesiology 2011; 28(8): 556-69;","DOI":"10.1097\/EJA.0b013e3283495ba1"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Chidambaran V, Costandi A, D'Mello A. Propofol: a review of its role in pediatric anesthesia and sedation. CNS Drugs. 2015 Jul; 29(7): 543-63. doi: 10.1007\/s40263-015-0259-6. Erratum in: CNS Drugs 2018; 32(9): 873;","DOI":"10.1007\/s40263-015-0259-6"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Anderson BJ, Bagshaw O. Practicalities of Total Intra-venous Anesthesia and Target-controlled Infusion in Children. Anesthesiology 2019; 131(1): 164-85;","DOI":"10.1097\/ALN.0000000000002657"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Fall M, Gueye D, Well\u00e9 IB, Lo FB, Sagna A, Diop M, Fall I. Laparoscopic Appendectomy in Children: Preliminary Study in Pediatric Hospital Albert Royer, Dakar. Gastroenterol Res Pract 2015; 2015: 878372;","DOI":"10.1155\/2015\/878372"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Otte A, Schindler E, Neumann C. Hamodynamisches Monitoring in der Kinderanasthesie Hemodynamic monitoring in pediatric anesthesia. Anaesthesiologie 2022; 71(6): 417-25;","DOI":"10.1007\/s00101-022-01125-8"},{"key":"ref22","unstructured":"Gupta R, Singh S. Challenges in paediatric laparoscopic surgeries. Indian J Anaesth 2009; 53(5): 560-6;"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Grabowski JE, Talamini MA. Physiological Effects of Pneumoperitoneum. J Gastrointest Surg 2008; 13(5): 1009-16;","DOI":"10.1007\/s11605-008-0662-0"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Kukanti C, Agrawal N, Karim HMR, Sinha M. Effect of Sevoflurane, Isoflurane, and Desflurane on the Random Blood Glucose Levels in Non-diabetic Patients Undergoing General Anesthesia: A Randomized, Single-Blind Study. Cureus 2024; 16(2): e54216;","DOI":"10.7759\/cureus.54216"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Casserly B, Phillips GS, Schorr C, Dellinger RP Townsend SR, Osborn TM, Reinhart K, Selvakumar N, Levy MM. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med 2015; 43(3): 567-73;","DOI":"10.1097\/CCM.0000000000000742"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Han RH, Huang HM, Han H, Chen H, Zeng F, Xie X , Liu DY, Cai Y, Zhang LQ, Liu X , Xia ZY, Tang J. Propofol postconditioning ameliorates hypoxia\/reoxygenation induced H9c2 cell apoptosis and autophagy via upregulating forkhead transcription factors under hyperglycemia. Mil Med Res 2021; 8(1): 58;","DOI":"10.1186\/s40779-021-00353-0"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Carles M, Dellamonica J, Roux J, Lena D, Levraut J, Pittet JF Boileau P Raucoules-Aime M. Sevoflurane but not propofol increases interstitial glycolysis metabolites availability during tourniquet-induced ischaemia-reperfusion. Br J Anaesth 2008; 100(1): 29-35;","DOI":"10.1093\/bja\/aem321"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Munde A, Kumar N, Beri RS, Puliyel JM. Lactate clearance as a marker of mortality in pediatric intensive care unit. Indian Pediatr 2014; 51(7): 565-7;","DOI":"10.1007\/s13312-014-0448-2"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Li H, Sun SR, Yap JQ, Chen JH, Qian Q. 0.9% saline is neither normal nor physiological. J Zhejiang Univ Sci B 2016; 17(3): 181-7;","DOI":"10.1631\/jzus.B1500201"},{"key":"ref30","unstructured":"van Balkom CAMK, de Beer SA, van Wijk MP Pl\u00f4tz FB. Gastric volvulus in children. Ned. Tijdschr. Geneeskd 2015; 159: A8641;"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Hemphill S, McMenamin L, Bellamy MC, Hopkins PM. Propofol infusion syndrome: a structured literature review and analysis of published case reports. Br J Anaesth 2019; 122(4): 448-59;","DOI":"10.1016\/j.bja.2018.12.025"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Brand, M.D. Mitochondrial generation of superoxide and hydrogen peroxide as the source of mitochondrial redox signaling. Free Radic Biol Med 2016; 100: 14-31;","DOI":"10.1016\/j.freeradbiomed.2016.04.001"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Dumlu EG, Toka\u00e7 M, Bozkurt B, Yildirim MB, Ergin M, Yal\u00e7in A, Kili\u00e7 M. Correlation between the serum and tissue levels of oxidative stress markers and the extent of inflammation in acute appendicitis. Clinics (Sao Paulo) 2014; 69(10): 677-82;","DOI":"10.6061\/clinics\/2014(10)05"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Liang TY, Peng SY Ma M, Li HY Wang Z, Chen G. Protective effects of sevoflurane in cerebral ischemia reperfusion injury: a narrative review. Med Gas Res 2021; 11(4): 152-4;","DOI":"10.4103\/2045-9912.318860"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Aktimur R, Gokakin AK, Deveci K, Atabey M, Topcu O. Oxidative stress markers in laparoscopic vs. open appendectomy for acute appendicitis: A double-blind randomised study. J Minim Access Surg 2016; 12(2): 143-7;","DOI":"10.4103\/0972-9941.156203"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Shin S, Na S, Kim OS, Choi YS, Kim SH, Oh YJ. Effect of Pneumoperitoneum on Oxidative Stress and Inflammation via the Arginase Pathway in Rats. Yonsei Med J 2016; 57(1): 238-46;","DOI":"10.3349\/ymj.2016.57.1.238"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Kundovi\u0107 SA, Ra\u0161i\u0107 D, Popovi\u0107 L, Peraica M, Crnjar K. Oxidative stress under general intravenous and inhalation anesthesia. Arh. Hig. Rada Toksikol 2020; 71(3): 169-77;","DOI":"10.2478\/aiht-2020-71-3437"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Simon P Burkhardt U, Sack U, Kaisers UX, Muensterer OJ. Inflammatory response is no different in children randomised to laparoscopic or open appendectomy. J Laparoendosc Adv Surg Tech A 2009; 19 Suppl 1: S71-6;","DOI":"10.1089\/lap.2008.0155.supp"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Colak E, Pap D. The role of oxidative stress in the development of obesity and obesity-related metabolic disorders. Jour Med Biochem 2021; 40: 1-9;","DOI":"10.5937\/jomb0-24652"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Mici\u0107 D, Lali\u0107 N, Djuki\u0107 V, Stankovi\u0107 S, Trajkovi\u0107 G, Olui\u0107 B, Polovina S. Influence of IL-6, TNF-a and Hs-CRP on Insulin Sensitivity in Patients after Laparoscopic Cholecystectomy or Open Hernia Repair. J Med Biochem 2018 Jul 1; 37(3): 328-35;","DOI":"10.1515\/jomb-2017-0043"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Hao W, Chan IHY, Liu X , Tang PMY, Tam PKH, Wong KKY. Early postoperative interleukin-6 and tumor necrosis factor-a levels after single-port laparoscopic varicocelectomy in children. Pediatr Surg Int 2012; 28(3): 281-6;","DOI":"10.1007\/s00383-011-3011-4"}],"container-title":["Journal of Medical Biochemistry"],"original-title":["Efekti propofola i sevoflurana na metaboli\u010dke promene i markere oksidativnog stresa kod laparoskopske apendektomije kod dece - klini\u010dko kontrolisano ispitivanje"],"language":"en","link":[{"URL":"https:\/\/scindeks-clanci.ceon.rs\/data\/pdf\/1452-8258\/2025\/1452-82582505110F.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T13:53:16Z","timestamp":1755784396000},"score":1,"resource":{"primary":{"URL":"https:\/\/scindeks.ceon.rs\/Article.aspx?artid=1452-82582505110F"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.5937\/jomb0-56035","relation":{},"ISSN":["1452-8258","1452-8266"],"issn-type":[{"value":"1452-8258","type":"print"},{"value":"1452-8266","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}