Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia
Ischemia reperfusion injury causes the release of free oxygen radicals. Free oxygen radicals initiate the production of toxic metabolites, such as malondialdehyde (MDA), through the lipid peroxidation of cellular membranes. Following lipid peroxidation, the antioxidant enzyme system is activated aga...
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| Format: | Article |
| Language: | English |
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Wiley
2013-02-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X12002148 |
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| author | Evrim Bostankolu Hilal Ayoglu Serhan Yurtlu Rahsan Dilek Okyay Gülay Erdogan Yeliz Deniz Volkan Hanci Murat Can Isil Ozkocak Turan |
| author_facet | Evrim Bostankolu Hilal Ayoglu Serhan Yurtlu Rahsan Dilek Okyay Gülay Erdogan Yeliz Deniz Volkan Hanci Murat Can Isil Ozkocak Turan |
| author_sort | Evrim Bostankolu |
| collection | DOAJ |
| description | Ischemia reperfusion injury causes the release of free oxygen radicals. Free oxygen radicals initiate the production of toxic metabolites, such as malondialdehyde (MDA), through the lipid peroxidation of cellular membranes. Following lipid peroxidation, the antioxidant enzyme system is activated against reactive oxygen species (ROS) and attempts to protect cells from oxidative damage. There is a balance between the scavenging capacity of antioxidant enzymes and ROS. Because of this balance, the total antioxidant capacity (TAC) measurement is a sensitive indicator of the overall protective effects of the antioxidants. Alpha2 receptor agonists are effective in preventing hemodynamic reactions during extremity surgeries by preventing the release of catecholamines secondary to tourniquet application. They have also been shown to possess preventive effects in various ischemia-reperfusion injury models. In our study, we examined the effects of dexmedetomidine on tourniquet-induced ischemia-reperfusion injury in lower extremity surgeries performed under general anesthesia. The effects of dexmedetomidine were measured with serum MDA and TAC levels. We studied 60 adult American Society of Anesthesiologists (ASA) physical status I or II patients undergoing one-sided lower extremity surgery with tourniquet. The patients were randomly divided into two groups. Group D was administered a dexmedetomidine infusion at a rate of 0.1 μg/kg/minute−1 for 10 minutes prior to induction and then at 0.7 μg/kg/hour−1 until 10 minutes before the end of the operation. The control group (Group C) received a saline infusion of the same amount and for the same period of time. General anesthesia was induced with thiopental, fentanyl, and rocuronium and maintained with nitrous oxide and sevoflurane in both groups. Venous blood samples were obtained before the administration of the study drugs (basal) at 1 minute before tourniquet release and at 5 and 20 minutes after tourniquet release (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p<0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p<0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia. |
| first_indexed | 2024-04-12T23:50:54Z |
| format | Article |
| id | doaj.art-f979a1df4c334b7eaded1e1c7c504547 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-04-12T23:50:54Z |
| publishDate | 2013-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-f979a1df4c334b7eaded1e1c7c5045472022-12-22T03:11:42ZengWileyKaohsiung Journal of Medical Sciences1607-551X2013-02-01292758110.1016/j.kjms.2012.08.013Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesiaEvrim Bostankolu0Hilal Ayoglu1Serhan Yurtlu2Rahsan Dilek Okyay3Gülay Erdogan4Yeliz Deniz5Volkan Hanci6Murat Can7Isil Ozkocak Turan8Department of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Biochemistry, School of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology and Reanimation, Zonguldak Karaelmas University, Zonguldak, TurkeyIschemia reperfusion injury causes the release of free oxygen radicals. Free oxygen radicals initiate the production of toxic metabolites, such as malondialdehyde (MDA), through the lipid peroxidation of cellular membranes. Following lipid peroxidation, the antioxidant enzyme system is activated against reactive oxygen species (ROS) and attempts to protect cells from oxidative damage. There is a balance between the scavenging capacity of antioxidant enzymes and ROS. Because of this balance, the total antioxidant capacity (TAC) measurement is a sensitive indicator of the overall protective effects of the antioxidants. Alpha2 receptor agonists are effective in preventing hemodynamic reactions during extremity surgeries by preventing the release of catecholamines secondary to tourniquet application. They have also been shown to possess preventive effects in various ischemia-reperfusion injury models. In our study, we examined the effects of dexmedetomidine on tourniquet-induced ischemia-reperfusion injury in lower extremity surgeries performed under general anesthesia. The effects of dexmedetomidine were measured with serum MDA and TAC levels. We studied 60 adult American Society of Anesthesiologists (ASA) physical status I or II patients undergoing one-sided lower extremity surgery with tourniquet. The patients were randomly divided into two groups. Group D was administered a dexmedetomidine infusion at a rate of 0.1 μg/kg/minute−1 for 10 minutes prior to induction and then at 0.7 μg/kg/hour−1 until 10 minutes before the end of the operation. The control group (Group C) received a saline infusion of the same amount and for the same period of time. General anesthesia was induced with thiopental, fentanyl, and rocuronium and maintained with nitrous oxide and sevoflurane in both groups. Venous blood samples were obtained before the administration of the study drugs (basal) at 1 minute before tourniquet release and at 5 and 20 minutes after tourniquet release (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p<0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p<0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia.http://www.sciencedirect.com/science/article/pii/S1607551X12002148DexmedetomidineIschemia reperfusion injuryMalondialdehydeTotal antioxidant capacity |
| spellingShingle | Evrim Bostankolu Hilal Ayoglu Serhan Yurtlu Rahsan Dilek Okyay Gülay Erdogan Yeliz Deniz Volkan Hanci Murat Can Isil Ozkocak Turan Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia Kaohsiung Journal of Medical Sciences Dexmedetomidine Ischemia reperfusion injury Malondialdehyde Total antioxidant capacity |
| title | Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia |
| title_full | Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia |
| title_fullStr | Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia |
| title_full_unstemmed | Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia |
| title_short | Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia |
| title_sort | dexmedetomidine did not reduce the effects of tourniquet induced ischemia reperfusion injury during general anesthesia |
| topic | Dexmedetomidine Ischemia reperfusion injury Malondialdehyde Total antioxidant capacity |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X12002148 |
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