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