Tourniquet-induced ischaemia-reperfusion injury: the comparison of antioxidativeeffects of small-dose propofol and ketamine
Ömer Karaca1, Nermin Göğüş2, Hüseyin Ulaş Pınar1
1Department of Anaesthesiology and Reanimation, Baskent University, Konya, Turkey
2Department of Anaesthesiology and Reanimation, Numune Training and Resourch Hospital, Ankara, Turkey
BACKGROUND AND AIM: The aim of the present study was to investigate the preventive effects of propofoland ketamine as small dose sedation during spinal anesthesia on tourniquet-induced ischemia--reperfusion injury.
MATERIAL AND METHODS: 30 patients were randomly assigned into two groups of 15 patients. In the propofolgroup, sedation was performed with propofol 0.2 mg.kg-1 followed by infusion at a rate of 2 mg.kg-1.h-1. In the ketamine group, a continuous infusion of ketamine 0.5 mg.kg-1.h-1 was useduntil the end of surgery. Intravenous administration of midazolam was not used in any patients.Ramsay sedation scale was used for assessing the sedation level. Venous blood samples wereobtained before propofol and ketamine infusion (T1), at 30 minutes (min) of tourniquet ischemia(T2), and 5 min after tourniquet deflation (T3) for malondialdehyde (MDA) measurements.
RESULTS AND DISCUSSION: No differences were noted between the groups in hemodynamic (p > 0.05) and demo-graphic data (p > 0.05). There was no statistically significant difference between the twogroups in terms of T1, T2 and T3 periods (p > 0.05). There was a statistically increase obser-ved in MDA values respectively both in Group P and Group K between the reperfusionperiod (1.95 ± 0.59, 2.31 ± 0.48) and pre-ischemia (1.41 ± 0.38, 1.54 ± 0.45), and ischemia(1.76 ± 0.70, 1.71 ± 0.38) (µmoL-1) periods (p < 0.05).
CONCLUSION(S): Small-dose propofol and ketamine has similar potential to reduce the oxidativestress caused by tourniquet-induced ischemia-reperfusion injury in patients undergoing arth-roscopic knee surgery under spinal anesthesia.
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