The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery

Abstract EN

Purpose.

To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA), ischemia-modified albumin (IMA) and neuromuscular side effects.

Methods.

Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups.

In Group S, intrathecal anesthesia was administered using levobupivacaine.

Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T.

Blood samples were obtained before the induction of anesthesia (t1), 30 min after tourniquet inflation (t2), immediately before (t3), and 5 min (t4), 15 min (t5), 30 min (t6), 1 h (t7), 2 h (t8), and 6 h (t9) after tourniquet release.

Results.

MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7.

MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9.

IMA levels in Group T were significantly lower than those in Group S at t2–t7.

Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I.

Conclusions.

TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.