Influence of anesthesia on lipidomic biomarkers in elderly patients undergoing hip replacement surgery

Abstract Purpose: The purpose of this study was to examine the effect of anesthesia on biomarkers of lipidomics in elderly patients with hip replacements. Methods: Elective hip replacement patients were randomly divided into general anesthesia group (group G) or spinal anesthesia group (group P). In group G, anesthesia was induced intravenously, ventilation was maintained with a laryngeal mask, and anesthesia was maintained with a combination of intravenous and inhaled agents. In group P, a single subarachnoid block with ropivacaine was administered. Venous blood samples(5 ml each) for analysis were collected from all patients before anesthesia, from group G after they fully awoke following surgery, from group P approximately 1 h after surgery. Results: In this study, a total of 42 plasma samples (24 from group G and 18 from group P) were analyzed by lipid spectrometry. A total of 1190 chemical species of lipids were detected, including 619 species of phospholipids, 512 species of glycerol lipids (GLs), 15 species of sphingolipids (SLs), 20 species of free fatty acids (FFAs), and 24 species of sterol lipids (STs). Compared with group P, group G showed increased levels of phosphatidylethanolamine (PE), phosphatidylserine (PS), and triacylglycerol (TAG) and decreased levels of phosphatidylinositol (PI). Conclusion: The plasma lipidomic features of elderly hip arthroplasty patients were changed by anesthesia; these changes included increases in phosphatidylethanolamine (PE), phosphatidylserine (PS), and triacylglycerol (TAG) and a decrease in phosphatidylinositol (PI) in group G compared to group P. The mechanism and pathophysiological correlates of these changes need further clinical study.