title: Ischaemic preconditioning attenuates haemodynamic response and lipid peroxidation in lower-extremity surgery with unilateral pneumatic tourniquet application: a clinical pilot study.
abstract: BACKGROUND
  The harmful effects of ischaemia-reperfusion on skeletal muscle during extremity surgery can be diminished by using medications or ischaemic preconditioning
  
  
  METHODS
  Twenty patients undergoing lower-limb surgery with use of a tourniquet for at least 1 hour were included in the study and randomised into two groups: a control group with only tourniquet application (T group; n=10); and an ischaemic preconditioning plus tourniquet group (IP-T group; n=10). Blood samples were obtained from the femoral vein of the relevant extremity before tourniquet application (baseline), immediately after tourniquet deflation (TD), at 10 minutes after the tourniquet deflation (TD(10min)) in the T group and additionally after ischaemic preconditioning in the IP-T group. Venous blood pH, partial oxygen pressure (P(vO2)), partial carbon dioxide pressure (P(vCO2)), lactate, potassium, sodium and glucose levels were analysed using a blood gas analyser. Plasma thiobarbituric acid reactive substances (TBARS) level, an index of lipid peroxidation and oxidative stress, was measured. Heart rate, noninvasive mean arterial pressure (MAP) and spontaneous breathing rate (SBR) were recorded at baseline, at TD, and TD(1min), TD(5min) and TD(10min).
  
  
  RESULTS
  MAP decreased and SBR increased significantly at TD, TD(1min) and TD(5min) compared with baseline, and venous blood TBARS level significantly increased at TD and TD(10min) compared with baseline in the T group (all P<0.05). No significant changes were observed in the IP-T group. Ischaemic preconditioning caused a rise in PvO2 and a decrease in venous blood pH, P(vCO2), and lactate levels, which was significant compared with baseline (P<0.05)
  
  
  CONCLUSIONS
  Ischaemic preconditioning attenuates haemodynamic response and lipid peroxidation during lower-extremity surgery with unilateral tourniquet application.
authors: Department of Anaesthesiology and Reanimation, State Hospital of Diyarbakir, Diyarbakir, Turkey.
authors: Mukaddes
authors: M
authors: Van
authors: Cimen
authors: C
authors: Olguner
authors: Uğur
authors: U
authors: Koca
authors: Ali Riza
authors: AR
authors: Sişman
authors: Kivanç
authors: K
authors: Muratli
authors: Ayşe
authors: A
authors: Karci
authors: Omür
authors: O
authors: Mavioğlu
authors: Hakan
authors: H
authors: Kilercik
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D001794:Blood Pressure; D005268:Femoral Vein; D006439:Hemodynamics; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D015227:Lipid Peroxidation; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000517:prevention & control*; D016037:Single-Blind Method; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014111:Tourniquets
chemical_list: D017392:Thiobarbituric Acid Reactive Substances