The effects of a small-dose ketamine-propofol combination on tourniquet-induced ischemia-reperfusion injury during arthroscopic knee surgery |
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| Affiliation: | 1. Anesthesiology and Reanimation Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey;2. Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Ankara, Turkey;1. Department of Emergency Medicine, Pamukkale University Hospital, Denizli, Turkey;2. Department of Emergency Medicine, Akdeniz University Hospital, Antalya, Turkey;1. Department of Anesthesiology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran;2. Department of Biochemistry, Center for Cellular and Molecular Research, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran;1. Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia;2. Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia;3. Critical Care and Perioperative Medicine, School of Clinical Sciences, Monash University, Melbourne, South Australia, Australia;4. Department of Oncology, Monash Health Translation Precinct, Monash University, Clayton, Australia;5. Forensic Science SA (FSSA), Adelaide, Australia |
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| Abstract: | Study ObjectiveTo determine the effects of a small-dose ketamine-propofol combination used for sedation during spinal anesthesia on tourniquet-induced ischemia-reperfusion injury.Study DesignProspective randomized study.SettingTraining and research hospital.Patients60 adult, ASA physical status 1 and 2 patients, ages 20–60 years, scheduled for elective arthroscopic knee surgery for meniscal and chondral lesions.InterventionsThe initial hemodynamic parameters were recorded and blood samples were collected at baseline (T1); then spinal anesthesia was performed. In Group I (n=30), a combination of 0.5 mg/kg/hr of ketamine and 2 mg/kg/hr of propofol was administered; Group II (n=30) received an equivalent volume of saline as an infusion. A pneumatic tourniquet was applied.MeasurementsMalondialdehyde (MDA), superoxide dismutase (SOD), and catalase levels were measured one minute before tournique deflation in the ischemic period (T2), then 5 (T3) and 30 (T4) minutes following tourniquet deflation in the reperfusion period.Main ResultsNo differences were noted between groups in hemodynamic data (P > 0.05) or SOD levels (P > 0.05). In Group I, MDA levels at T2 were lower than in Group II (P < 0.05). In Group I, catalase levels were lower at T2 and T4 than they were in Group II (P < 0.05).ConclusionSmall-dose ketamine-propofol combination may be useful in reducing tourniquet-induced ischemia-reperfusion injury in arthroscopic knee surgery. |
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