• Logo
  • SBMUJournals

The Balance between Pro-oxidants and Antioxidants in Cardiac Anesthesia: a Review

Seyed Mohammad Seyed-Alshohadaei




Due to the development of surgical techniques for controlling the conditions of patients, we are still faced with many conditions and risks in the management of patients' health during and after surgery. Hence, the creation of new methods, access to medicines and things that increase the quality of management and improve patient control conditions are on the agenda of many research teams around the world. Antioxidant substances and their effects on the control of free radicals (as one of the destructive factors on the health of patients undergoing surgery) is one of the research cases that has attracted many researchers in recent years. Cardiac surgery and cardiac anesthesia are among the most challenging types of surgeries. Control and management of patient conditions during this type of surgery is one of the most important challenges of anesthesiology team. This study tries to investigate the importance of antioxidants in controlling conditions and improving the status of patients undergoing cardiac surgery.

Keywords: Antioxidant; Pro-oxidant; Cardiac Anesthesia; Inflammation


Antioxidant; oxidants ; pro oxidant ;cardiac surgery ; CABG ; antioxidant balance ; carioplegi ; cardiac pump



Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. Int J Biomed Sci. 2008; 4(2): 89–96.

Sies H. Oxidative stress: oxidants and antioxidants. Exp Physiol. 1997;82(2):291-5.

Zubrzycki M, Liebold A, Skrabal C, Reinelt H, Ziegler M, Perdas E, Zubrzycka M. Assessment and pathophysiology of pain in cardiac surgery. J Pain Res. 2018; 11: 1599–611.

Cai GH, Huang J, Zhao Y, Chen J, Wu HH, Dong YL, Smith HS, Li YQ, Wang W, Wu SX. Antioxidant therapy for pain relief in patients with chronic pancreatitis: systematic review and meta-analysis. Pain Physician. 2013;16(6):521-32.

Stanger O, Aigner I, Schimetta W, Wonisch W. Antioxidant supplementation attenuates oxidative stress in patients undergoing coronary artery bypass graft surgery. Tohoku J Exp Med. 2014;232(2):145-54.

Zakkar M, Guida G, Suleiman M, Angelini GD. Cardiopulmonary bypass and oxidative stress. Oxid Med Cell Longev. 2015;2015:189863.

Santanam N, Kavtaradze N, Murphy A, Dominguez C, Parthasarathy S. Antioxidant supplementation reduces endometriosis-related pelvic pain in humans. Transl Res. 2013;161(3):189-95.

Carr AC, McCall C. The role of vitamin C in the treatment of pain: new insights. J Transl Med. 2017;15(1):77.

Zhan L, Li R, Sun Y, Dou M, Yang W, He S, Zhang Y. Effect of mito-TEMPO, a mitochondria-targeted antioxidant, in rats with neuropathic pain. Neuroreport. 2018;29(15):1275-81.

Maglione E, Marrese C, Migliaro E, et al. Increasing bioavailability of (R)-alpha-lipoic acid to boost antioxidant activity in the treatment of neuropathic pain. Acta Biomed. 2015;86(3):226-33.

Rokyta R, Holecek V, Pekárková I, et al. Free radicals after painful stimulation are influenced by antioxidants and analgesics. Neuro Endocrinol Lett. 2003;24(5):304-9.

Rahsepar AA, Mirzaee A, Moodi F, Moohebati M, Tavallaie S, Khorashadizadeh F, Mottahedi B, Esfehanizadeh J, Azari A, Sajjadian M, Khojasteh R, Paydar R, Mousavi S, Amini M, Ghayour-Mobarhan M, Ferns GA. Prooxidant-antioxidant balance and cardiac function in patients with cardiovascular disease following cardiac surgery. J Heart Valve Dis. 2013;22(3):408-17.

Baikoussis NG, Papakonstantinou NA, Verra C, Kakouris G, Chounti M, Hountis P, Dedeilias P, Argiriou M. Mechanisms of oxidative stress and myocardial protection during open-heart surgery. Ann Card Anaesth. 2015;18(4):555-64.

Fudulu DP, Gibbison B, Upton T, Stoica SC, Caputo M, Lightman S, Angelini GD. Corticosteroids in Pediatric Heart Surgery: Myth or Reality. Front Pediatr. 2018;6:112.

Moris D, Spartalis M, Tzatzaki E, Spartalis E, Karachaliou GS, Triantafyllis AS, Karaolanis GI, Tsilimigras DI, Theocharis S. The role of reactive oxygen species in myocardial redox signaling and regulation. Ann Transl Med. 2017;5(16):324.

Fudulu D, Angelini G. Oxidative stress after surgery on the immature heart. Oxid Med Cell Longev. 2016;2016:1971452.

Zhang J, Zhou X, Wu W, Wang J, Xie H, Wu Z. Regeneration of glutathione by α-lipoic acid via Nrf2/ARE signaling pathway alleviates cadmium-induced HepG2 cell toxicity. Environ Toxicol Pharmacol. 2017;51:30-7.

Zhang H, Limphong P, Pieper J, Liu Q, Rodesch CK, Christians E, Benjamin IJ. Glutathione-dependent reductive stress triggers mitochondrial oxidation and cytotoxicity. The FASEB J. 2012;26(4):1442-51.

Korge P, Calmettes G, Weiss JN. Increased reactive oxygen species production during reductive stress: the roles of mitochondrial glutathione and thioredoxin reductases. Biochim Biophys Acta. 2015;1847(6-7):514-25.

Handy DE, Loscalzo J. Responses to reductive stress in the cardiovascular system. Free Radic Biol Med. 2017 Aug;109:114-24.

Mentese U, Dogan OV, Turan I, Usta S, Dogan E, Mentese SO, Demir S, Ozer T, Aykan AC, Alver A. Oxidant-antioxidant balance during on-pump coronary artery bypass grafting. ScientificWorldJournal. 2014;2014:263058.

Peng JR, Lu TT, Chang HT, Ge X, Huang B, Li WM. Elevated levels of plasma superoxide dismutases 1 and 2 in patients with coronary artery disease. Biomed Res Int. 2016;2016:3708905.

Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Cl Clin Biochem. 2004;37(2):112-9.

Ahmadnezhad M, Arefhosseini SR, Parizadeh MR, Tavallaie S, Tayefi M, Darroudi S, Ghazizadeh H, Moohebati M, Ebrahimi M, Heidari-Bakavoli A, Azarpajouh MR, Ferns GA, Mogharebzadeh V, Ghayour-Mobarhan M. Association between serum uric acid, highly sensitive C‐reactive protein and pro‐oxidant‐antioxidant balance in patients with metabolic syndrome. Biofactors. 2018;44(3):263-71.

DOI: https://doi.org/10.22037/jcma.v3i3.23158


  • There are currently no refbacks.