title: Tourniquet-induced ischemia-reperfusion injuries during extremity surgery at children's age: impact of anesthetic chemical structure.
abstract: OBJECTIVE
  The aim of this study was to determine the relationship between the antioxidant profile of anesthetics and its relation to total antioxidant capacity (TAC) of plasma in children who underwent tourniquet-induced ischemia-reperfusion (IR) injury during extremity  operations.
  
  
  METHODS
  Children were randomized into three groups: general inhalational anesthesia with sevoflurane (group S), total intravenous anesthesia (TIVA) with propofol (group T), and regional anesthesia (group R). Venous blood samples were obtained before peripheral  nerve block and induction of general anesthesia (baseline), 1 minute before tourniquet release (BTR), and 5 and 20 minutes after tourniquet release (ATR). Plasma TAC as well as antioxidant potential of propofol, thiopental, and bupivacaine were measured using the 2,2-diphenyl-1-picrylhydrazyl  (DPPH) assay.
  
  
  RESULTS
  Plasma TAC in group T was increased significantly at 20 minutes ATR in comparison with basal and BTR values, and also was significantly higher in comparison with plasma TAC in groups S and R measured at the same time point. The radical scavenging activity  of anesthetics in vitro indicated that only propofol possessed a significant antioxidative activity in the reaction with DPPH radical in comparison with thiopental and bupivacaine.
  
  
  CONCLUSIONS
  These data confirm that TIVA with propofol attenuates oxidative stress  related to tourniquet-induced ischaemia-reperfusion injury in children.
authors: Centre for Anesthesia, Clinical Centre Nis, Nis, Serbia. ibudic@open.telekom.rs
authors: Ivana
authors: I
authors: Budic
authors: Dusica
authors: D
authors: Pavlovic
authors: Dusanka
authors: D
authors: Kitic
authors: Gordana
authors: G
authors: Kocic
authors: Tatjana
authors: T
authors: Cvetkovic
authors: Dusica
authors: D
authors: Simic
authors: Tatjana
authors: T
authors: Jevtovic-Stoimenov
mesh_terms: D000293:Adolescent; D000765:Anesthesia, Conduction; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation; D000975:Antioxidants / Q000378:metabolism; D001713:Biphenyl Compounds / Q000378:metabolism; D002045:Bupivacaine / Q000494:pharmacology; D002648:Child; D005121:Extremities / Q000601:surgery*; D005260:Female; D016166:Free Radical Scavengers / Q000378:metabolism / Q000494:pharmacology; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D018384:Oxidative Stress / Q000187:drug effects*; D010851:Picrates / Q000378:metabolism; D015742:Propofol / Q000494:pharmacology; D015427:Reperfusion Injury / Q000378:metabolism* / Q000473:pathology; D000077149:Sevoflurane; D013874:Thiopental / Q000494:pharmacology; D014111:Tourniquets / Q000009:adverse effects*
chemical_list: D018685:Anesthetics, Inhalation; D000975:Antioxidants; D001713:Biphenyl Compounds; D016166:Free Radical Scavengers; D008738:Methyl Ethers; D010851:Picrates; D000077149:Sevoflurane; C004931:1,1-diphenyl-2-picrylhydrazyl; D013874:Thiopental; D002045:Bupivacaine; D015742:Propofol
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