title: An evaluation of the effects of perioperatively administered fluids on ischemia/reperfusion injury.
abstract: OBJECTIVE
  To investigate the effects of normal saline (0.9% NaCl) and 6% Hydroxyethyl Starch 130/0.4(HES) solution on Ischemia/Reperfusion (I/R) injury in patients undergoing knee arthroscopy operations with spinal anesthesia using a tourniquet.
  
  
  METHODS
  The study comprised 48 ASA I-II patients undergoing knee arthroscopy with spinal anesthesia using a tourniquet. The patients were randomised into two groups and after standard monitoring two venous lines were introduced to obtain blood samples and to give intravenous therapy. In the control group (Group A) (n=21) 0.9% NaCl, 10 ml/kg/hours and in the study group (Group B) (n=19) 6% Hydroxyethyl Starch 130/0.4, 10 ml/kg/hours infusion were administered. Spinal anesthesia was applied with 12.5 mg hyperbaric bupivacaine to all patients. The tourniquet was applied and the operation was started when the sensorial block level reached T10 dermatome. Blood xanthine oxidase (XO) and malondialdehyde (MDA) levels as an indicator of ischemia and reperfusion injury were measured in samples before fluid infusion (t1), before tourniquet application (t2), 1 minute before tourniquet release (t3), and at 5 (t4) and 15 (t5) minutes after tourniquet release.
  
  
  RESULTS
  No difference was observed between the two groups in respect of demographic parameters, the highest block level, duration before tourniquet application and tourniquet duration (p>0.05). The MDA level after tourniquet application and 15 minutes after tourniquet release was lower in Group B (p<0.05). XO levels were not different (p>0.05).
  
  
  CONCLUSIONS
  In this study 6% Hydroxyethyl Starch 130/0.4 solution reduced MDA level which is an indicator of lipid peroxidation. 6% Hydroxyethyl Starch 130/0.4 solution may be beneficial for Ischemia/reperfusion injuries.
authors: S. Ozciftci, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: S
authors: S
authors: Ozciftci
authors: M. Gamli, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: M
authors: M
authors: Gamli
authors: D. Ornek, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: D
authors: D
authors: Ornek
authors: E. Horasanli, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: E
authors: E
authors: Horasanli
authors: B. Dikmen, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: B
authors: B
authors: Dikmen
authors: O. Canpolat, Gazi University, Biochemistry Department, Ankara, Turkey.
authors: O
authors: O
authors: Canpolat
authors: M.Z. Ciraci, Gazi University, Biochemistry Department, Ankara, Turkey.
authors: M Z
authors: MZ
authors: Ciraci
authors: O. Kilci, Ankara Numune Training & Research Hospital, Anesthesiology & Reanimation Department, Ankara, Turkey.
authors: O
authors: O
authors: Kilci
keywords: Intravenos fluids; Ischemia/Reperfusion injury; Malondialdehyde; Xanthine oxidase