The effects of a small-dose ketamine-propofol combination on tourniquet-induced ischemia-reperfusion injury during arthroscopic knee surgery.
OBJECTIVE
To determine the effects of a small-dose ketamine-propofol combination used for sedation during spinal anesthesia on tourniquet-induced ischemia-reperfusion injury.


METHODS
Prospective randomized study.


METHODS
Training and research hospital.


METHODS
60 adult, ASA physical status 1 and 2 patients, ages 20-60 years, scheduled for elective arthroscopic knee surgery for meniscal and chondral lesions.


METHODS
The initial hemodynamic parameters were recorded and blood samples were collected at baseline (T1); then spinal anesthesia was performed. In Group I (n=30), a combination of 0.5 mg/kg/hr of ketamine and 2 mg/kg/hr of propofol was administered; Group II (n=30) received an equivalent volume of saline as an infusion. A pneumatic tourniquet was applied.


METHODS
Malondialdehyde (MDA), superoxide dismutase (SOD), and catalase levels were measured one minute before tournique deflation in the ischemic period (T2), then 5 (T3) and 30 (T4) minutes following tourniquet deflation in the reperfusion period.


RESULTS
No differences were noted between groups in hemodynamic data (P > 0.05) or SOD levels (P > 0.05). In Group I, MDA levels at T2 were lower than in Group II (P < 0.05). In Group I, catalase levels were lower at T2 and T4 than they were in Group II (P < 0.05).


CONCLUSIONS
Small-dose ketamine-propofol combination may be useful in reducing tourniquet-induced ischemia-reperfusion injury in arthroscopic knee surgery.
Anesthesiology and Reanimation Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Nermin
N
Gogus
Anesthesiology and Reanimation Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey. Electronic address: belginakan@yahoo.com.
Belgin
B
Akan
Anesthesiology and Reanimation Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Sinem
S
Bayrakci
Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey.
Gozde
G
Girgin
Anesthesiology and Reanimation Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Mustafa
M
Baydar
D000328:Adult; D000700:Analgesics / Q000097:blood / Q000494:pharmacology; D000775:Anesthesia, Spinal / Q000379:methods; D019162:Anesthetics, Combined / Q000097:blood / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000097:blood / Q000494:pharmacology; D001182:Arthroscopy / Q000379:methods*; D002374:Catalase / Q000097:blood / Q000187:drug effects; D005260:Female; D006801:Humans; D007649:Ketamine / Q000097:blood / Q000494:pharmacology*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D015742:Propofol / Q000097:blood / Q000494:pharmacology*; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000097:blood / Q000517:prevention & control*; D013482:Superoxide Dismutase / Q000097:blood / Q000187:drug effects; D014111:Tourniquets / Q000009:adverse effects*; D055815:Young Adult
D000700:Analgesics; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D008315:Malondialdehyde; D007649:Ketamine; D002374:Catalase; D013482:Superoxide Dismutase; D015742:Propofol
Arthroscopic knee surgery; Catalase; Ischemia-reperfusion injury; Ketamine; Malondialdehyde; Orthopedic surgery; Pneumatic tourniquet; Propofol; Superoxide dismutase