1. Introduction
DNA DAMAGE, OXIDATIVE STRESS, GENOTOXICITY, SECONDARY
About 100 million patients undergo surgical procedures every year globally [Among inhaled anesthetic gases, isoflurane (ISO) is one of the most widely used agents in clinics because of its low solubility and slow metabolism [Oxidative stress-induced by reactive oxygen species (ROS) species. This ROS causes protein denaturation that leads to mitochondrial DNA damage [Dexmedetomidine (DEX) is a centrally acting Using DEX infusion for sedation during surgery may reduce the genotoxicity of inhalational anesthetic. To our knowledge, no previous study conducted to evaluate the antioxidant activity, genoprotective effect, and safety evaluation of DEX infusion with the use of ISO in humans so far. The proposed research work was designed to evaluate the genotoxicity of anesthesia maintained with ISO alone and combination of ISO and DEX infusion on DNA damage (as a primary outcome), oxidative stress response, and antioxidants level (as a secondary outcome) in patients scheduled for an elective major invasive neurosurgical procedure.