title: Effect of hydroxyethyl starch 130/0.4 on ischemia-reperfusion determinants in minor lower extremity surgery with tourniquet application.
abstract: OBJECTIVE
  To investigate the effect of 6% hydroxyethyl starch (HES) (130/0.4) infusion on ischemia-reperfusion determinants in minor lower extremity operations with tourniquet application.
  
  
  METHODS
  Prospective, randomized, clinical trial.
  
  
  METHODS
  University hospital operation room.
  
  
  METHODS
  American Society of Anesthesiologists I and II 40 patients between 18 and 65 years of age who were scheduled to undergo knee arthroscopy and below-knee minor orthopedic surgery.
  
  
  METHODS
  Patients were randomized into 2 groups (normal saline [NS] group and HES group). Unilateral spinal anesthesia with 2-mL 0.5% hyperbaric bupivacaine after 10 mL/kg NS intravenous infusion to NS group and 10 mL/kg 6% HES intravenous infusions to HES group.
  
  
  METHODS
  Blood samples were obtained from antecubital vein for malondialdehyde, xanthine oxidase, and hypoxanthine before tourniquet inflation and after 10 minutes of tourniquet deflation.
  
  
  RESULTS
  There was no significant difference between groups with respect of hemodynamic data. There were no significant differences between 2 groups in terms of malondialdehyde values before tourniquet inflation and after tourniquet deflation. In the HES group, xanthine oxidase levels after tourniquet deflation were significantly lower than xanthine oxidase levels before tourniquet inflation (P < .05). In the HES group, hypoxanthine levels after tourniquet deflation were similar with the basal levels; however, they were significantly higher than levels obtained before tourniquet inflation in the SF group (P < .05).
  
  
  CONCLUSIONS
  HES infusion may be beneficial for reduction of tourniquet-associated ischemia-reperfusion injury; however, further large-scale studies are needed to fully elucidate its mechanism.
authors.affiliation: Department of Anesthesiology, Baskent University Medicine Faculty, Ankara, Turkey. Electronic address: huseyinpinar2002@yahoo.com.
authors.forename: Hüseyin Ulaş
authors.initials: HU
authors.lastname: Pinar
authors.affiliation: Department of Anesthesiology, Medicana Hospital, Konya, Turkey.
authors.forename: Aşina
authors.initials: A
authors.lastname: Pinar
authors.affiliation: Department of Anesthesiology, Dokuz Eylul University Medicine Faculty (retired), Izmir, Turkey.
authors.forename: Ömür
authors.initials: Ö
authors.lastname: Mavioğlu
authors.affiliation: Department of Biochemistry, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Nilgün
authors.initials: N
authors.lastname: Yener
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods; D001182:Arthroscopy; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D019271:Hypoxanthine / Q000097:blood; D007719:Knee Joint / Q000601:surgery; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010952:Plasma Substitutes / Q000627:therapeutic use; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D014111:Tourniquets / Q000009:adverse effects*; D014969:Xanthine Oxidase / Q000097:blood; D055815:Young Adult
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D019271:Hypoxanthine; D008315:Malondialdehyde; D014969:Xanthine Oxidase
keywords: Hydroxyethyl starch; Ischemia-reperfusion injury; Tourniquet