title: The effects of dexmedetomidine on ischemia reperfusion injury in patients undergoing arthroscopy under spinal anesthesia.
abstract: OBJECTIVE
  Ischemia and reperfusion injury due to tourniquet application during arthroscopy is a well known problem. This study aimed to compare the effects of dexmedetomidine and ketamine on hemodynamic and respiratory variables and on total anti-oxidant status (TAS), total oxidant status (TOS) and malondialdehyde (MDA) as markers of ischemia-reperfusion injury.
  
  
  METHODS
  This study was approved by a local ethics committee. The study was performed on patients undergoing arthroscopic operation under spinal anesthesia. Thirty patients were randomized into two groups: Group D (dexmedetomidine; n=15) and Group K (Ketamine; n=15). Spinal anesthesia at the L2-4 level was achieved using a 25G spinal needle with hyperbaric bupivacaine at a dose of 12-15 mg in all patients. In Group D, patients were sedated with dexmedetomidine at a dose of 0.3-0.5 μg/kg/h, while Group K received ketamine at a dose of 1-1.5 mg/kg/h. Hemodynamic parameters, oxygen saturation, Ramsey sedation scale (RSS), and TAS, TOS, and MDA levels were recorded.
  
  
  RESULTS
  Demographic parameters, TAS, TOS and MDA levels were similar between groups. In Group K, the TOS levels after tourniquet removal were significantly lower than at baseline and during the use of the tourniquet. Preoperative hemodynamic and respiratory variables were similar in both groups. Blood pressure values were decreased compared to baseline but these decreases were not statistically significant.
  
  
  CONCLUSIONS
  In patients undergoing arthroscopy under spinal anesthesia, dexmedetomidine had effects similar to ketamine, led to insignificant alterations in hemodynamic and respiratory variables during surgery and had comparable effects on ischemia-reperfusion injury. Thus, we think that dexmedetomidine can be a safe alternative to ketamine as an intraoperative sedative.
authors.affiliation: Department of Anesthesiology and Reanimation, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Senem
authors.initials: S
authors.lastname: Koruk
authors.affiliation: Department of Anesthesiology and Reanimation, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Mizrak
authors.affiliation: Department of Anesthesiology and Reanimation, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Recai
authors.initials: R
authors.lastname: Kaya
authors.affiliation: Department of Anesthesiology and Reanimation, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Ugur
authors.affiliation: Department of Orthopedics, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Cebesoy
authors.affiliation: Department of Biochemistry, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
authors.affiliation: Department of Anesthesiology and Reanimation, Medical School, Gaziantep University, Gaziantep, Turkey.
authors.forename: Unsal
authors.initials: U
authors.lastname: Oner
keywords: Dexmedetomidine; Ischemia reperfusion; Ketamine; Oxidative stress