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Background: Laparoscopy is a popular minimally invasive surgical method due to its low surgical risk and postoperative complication rates. Laparoscopic surgery requires pneumoperitoneum conditions with CO2 gas which potentially increases intraperitoneal pressure and can cause ischemic injury to the gastrointestinal tract. Intestinal
Fatty Acid-Binding Protein (I-FABP) is a sensitive biomarker for detecting gastrointestinal ischemia.
Aim: This study aims to compare changes in I-FABP levels in laparoscopic surgery with TIVA Propofol anesthesia maintenance versus Sevoflurane inhalation.
Materials and Methods: A cross-sectional analytical observational study was conducted at Universitas Airlangga Hospital, involving 20 adult patients scheduled for elective laparoscopic procedures. Participants were randomized into two groups: TIVA propofol (n=10) and sevoflurane inhalation (n=10). Exclusion criteria included abdominal
trauma, gastrointestinal obstruction or perforation, COVID-19, and severe comorbidities. Serum I-FABP levels were measured after intubation (baseline, prior to pneumoperitoneum) and 30 minutes after extubation using enzymelinked immunosorbent assay (ELISA). Statistical analyses included paired t-tests for within-group comparisons and independent t-tests for between-group differences, with significance set at p<0.05.
Results: Both groups demonstrated a significant reduction in I-FABP levels postoperatively (p<0.001). The sevoflurane group exhibited a greater mean reduction in I-FABP (27.2 ± 5.07 ng/mL) compared to the TIVA propofol group (19.19 ± 3.95 ng/mL), with the inter-group difference reaching statistical significance (p<0.05). No severe hemodynamic or respiratory complications were observed in either group.
Conclusion: Sevoflurane inhalation anesthesia was associated with a significantly greater reduction in postoperative serum I-FABP levels than TIVA propofol, suggesting superior protection against gastrointestinal ischemic injury during laparoscopic surgery. Both anesthetic techniques were safe and effective, supporting their use according to
patient-specific considerations.