Leukocyte telomere length changes following various anesthetic methods in patients with severe combined trauma

Background. In recent decades, the number of surgical interventions has increased in the world. In clinical practice, it is not always possible to assess long-term changes/complications/outcomes. The other side of technological progress includes patient satisfaction with medical care and desire for active longevity. Quality and safety of anesthesia, as well as its impact on humans are actively discussed in global community. Epigenetics is one of the new directions in anesthesiology. At the moment, the effect of anesthesia on genome is not established. Objective. To study leukocyte telomere length in patients with severe concomitant trauma undergoing repeated anesthesia. Material and methods. A prospective cohort study included 41 victims with severe combined trauma. The first group included patients who underwent regional anesthesia with propofol sedation (RA), the second group — general combined anesthesia (GA). Twice blood sampling was performed for laboratory diagnostics. We analyzed leukocyte telomere length using real-time PCR before treatment and 4 weeks after admission. Results. There were no significant between-group differences after 4 weeks (p=0.933). In the first group, there was significantly shorter leukocyte telomere length in 4 weeks after admission (p=0.002282). Conclusion. General anesthesia does not affect the length of leucocyte telomeres. Telomere shortening was observed after regional anesthesia, but appropriate values were within normal limits. Probably, this shortening was short-term, and restoration of baseline telomere length is possible. It is not possible to answer the question about the causes of telomere shortening unambiguously. Further studies of epigenetic aspects of anesthesiology are needed.