The effects of spinal, inhalation, and total intravenous anesthetic techniques on ischemia-reperfusion injury in arthroscopic knee surgery.
OBJECTIVE
To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects.


METHODS
Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1), 30 min after tourniquet inflation (t2), immediately before (t3), and 5 min (t4), 15 min (t5), 30 min (t 6), 1 h (t7), 2 h (t8), and 6 h (t9) after tourniquet release.


RESULTS
MDA and IMA levels increased significantly compared with baseline values in Group S at t2-t 9 and t2-t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2-t8 and t2-t9. IMA levels in Group T were significantly lower than those in Group S at t2-t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I.


CONCLUSIONS
TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.
Department of Anesthesiology, KTU Farabi Hospital, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Müge
M
Koşucu
Department of Anesthesiology, KTU Farabi Hospital, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Ilker
I
Coşkun
Department of Anesthesiology, KTU Farabi Hospital, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Ahmet
A
Eroglu
Department of Anesthesiology, KTU Farabi Hospital, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Dilek
D
Kutanis
Department of Biochemistry, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Ahmet
A
Menteşe
Department of Biochemistry, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
S Caner
SC
Karahan
Department of Orthopaedics, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Emre
E
Baki
Department of Orthopaedics, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Servet
S
Kerimoğlu
Department of Public Health, Medical School of Karadeniz Technical University, 61080 Trabzon, Turkey.
Murat
M
Topbas
D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000775:Anesthesia, Spinal; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee; D001241:Aspirin / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D002744:Chlorpheniramine / Q000008:administration & dosage; D011431:Dextropropoxyphene / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D015427:Reperfusion Injury / Q000097:blood* / Q000209:etiology; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D004338:Drug Combinations; D008738:Methyl Ethers; C004575:propofan; D000082:Acetaminophen; D000077149:Sevoflurane; D002744:Chlorpheniramine; D008315:Malondialdehyde; D000077554:Levobupivacaine; D001241:Aspirin; D011431:Dextropropoxyphene; D002045:Bupivacaine