Different oxidative stress marker levels in blood from the operated knee or the antecubital vein in patients undergoing knee surgery: a tourniquet-induced ischemia-reperfusion model.
BACKGROUND
In knee surgery a tourniquet is usually applied in order to provide a bloodless surgical field. This study aims to compare, in a tourniquet-induced ischemia-reperfusion model, the glutathione oxidation and lipid peroxidation in two different blood sources: an operated knee drainage tube or the antecubital vein.


METHODS
Thirty-two patients undergoing total knee replacement were studied. We measured reduced glutathione (GSH), oxidized glutathione (GSSG), malondialdehyde (MDA) and other metabolic parameters in the blood from the operated knee (17 patients), or from the antecubital vein (15 patients) before tourniquet inflation (T(0)) and after tourniquet release at different times: 3, 10, and 60 minutes (T(1), T(2), and T(3), respectively).


RESULTS
We have found an early increase of approximately 100% in GSSG and MDA blood levels coinciding with a decrease in GSH levels at T(1)-T(3) in blood from the operated knee. These changes were also observed in blood from the antecubital vein at T(1) and T(2), but at lower levels than in blood from the operated knee.


CONCLUSIONS
There is an intense glutathione oxidation and lipid peroxidation in the operated knee after tourniquet deflation. The surgical drainage is a good source of blood for the determination of biomarkers in a tourniquet-induced ischemia-reperfusion model, because changes are observed more early and it is more direct than another source of systemic blood.
Department of Anesthesiology and Critical Care, Hospital Clínico Universitario de Valencia, Fundación Investigación Clínico de Valencia, Instituto de Investigación Sanitaria, Valencia, Spain.
José
J
García-de-la-Asunción
Amparo
A
Perez-Solaz
Miguel
M
Carrau
Francisco Javier
FJ
Belda
Jaime
J
Perez-Griera
Beatriz
B
Garriges
D019645:Arthroplasty, Replacement, Knee; D005978:Glutathione / Q000097:blood / Q000378:metabolism; D019803:Glutathione Disulfide / Q000097:blood / Q000378:metabolism; D006801:Humans; D007717:Knee / Q000601:surgery; D015227:Lipid Peroxidation / Q000502:physiology; D008315:Malondialdehyde / Q000097:blood / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology*; D015427:Reperfusion Injury / Q000097:blood* / Q000378:metabolism*; D014111:Tourniquets / Q000009:adverse effects*
D008315:Malondialdehyde; D005978:Glutathione; D019803:Glutathione Disulfide