Role of Glucocorticoids during Sevoflurane Anaesthesia in Tourniquet-induced Ischemiareperfusion Injury


Sepici Dinçel A. , Özkan Y. , İzdeş S., Gözdemir M., Kanbak O.

Oxidation Communications, cilt.32, sa.1, ss.226-235, 2009 (SCI Expanded İndekslerine Giren Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Konu: 1
  • Basım Tarihi: 2009
  • Dergi Adı: Oxidation Communications
  • Sayfa Sayıları: ss.226-235

Özet

Abstract

Oxygen-free radicals are considered to be important components involved in the

physiopathological tissue alterations observed during ischemia/reperfusion (I/R).

The application and release of tourniquets is often used in lower extremity surgery in

order to obtain a clear operative field and to reduce blood loss. When the tourniquet

is released, excessive formation of free radicals follows reperfusion and oxygenation.

This study was designed to investigate two different doses of methylprednisolone (MP)

administration effects in tourniquet-induced IR injury during exposure to sevoflurane

anaesthesia.

This placebo control study was designed to compare the effects of two doses of

MP onto the I/R injury in patients in whom the tourniquet was used during elective

lower extremity surgery under general anaesthesia with sevoflurane. 37 ASA physical

status I or II patients scheduled for elective lower extremity surgery received MP

5 mg kg–1, 1 mg kg–1, respectively, following the induction of anaesthesia. Blood

samples were drawn immediately before ischemia, end of ischemia and at 5, 30 min

and 24 h of reperfusion.

The main findings were that sevoflurane by itself or with 5 mg kg–1 doses of MP

could be protective against I/R injury of tissue depending on the free radical scavenging

features (MDA, FOX) and antioxidant effects (SOD), but not as effective as

a protective agent against endothelial cell injury (nitrite-nitrate). Besides MP has an

additive anti-lipid peroxidation activity and might be protective against reperfusion

injury to endothelial cells.

Keywords: ischemia-reperfusion, sevaflurane, antioxidants, lipid peroxidation.