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

摘要

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 (t 1), 30 min after tourniquet inflation (t 2), immediately before (t 3), and 5 min (t 4), 15 min (t 5), 30 min (t 6), 1 h (t 7), 2 h (t 8), and 6 h (t 9) after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t 2–t 9 and t 2–t 7. MDA levels in Group T and Group I were significantly lower than those in Group S at t 2–t 8 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.