THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET

ÇAĞLAYAN, Osman; ÇETİK, Özgür; KAYMAK, CETİN; APAN, Alpaslan; ÇAKIRCA, Mehmet

THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET

Çetin KAYMAK, (Ankara Training and Research Hospital, Ministry of Health, Department of Anaesthesiology and Reanimation, Ankara, Türkiye)

Özgür ÇETİK, (Medical Faculty of Kirikkale University, Department of Ortopedia and Traumatology, Kırıkkale, Ankara)

Mehmet ÇAKIRCA, (Ankara Training and Research Hospital, Ministry of Health, Department of Anaesthesiology and Reanimation, Ankara, Türkiye)

Osman ÇAĞLAYAN, (Prof. Medical Faculty of Kirikkale University, Department of Biochemistry, Kırıkkale, Ankara)

Alpaslan APAN (Prof., Medical Faculty of Kirikkale University, Department of Anaesthesiology and Reanimation, Kırıkkale, Ankara)

Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi

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Yıl: 2015 Cilt: 48 Sayı: 1 Sayfa Aralığı: 5 - 12 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET

Öz:

AMAÇ:Artroskopik diz cerrahisinde cerrahi alan görüşünü arttırmak amacıyla sıklıkla turnike uygulanmaktadır. Bununla beraber turnikenin indirilmesi ile beraber iskemi/reperfüzyon hasarı gelişmektedir. Bu çalışmanın amacı turnike altında gerçekleşen artroskopik diz cerrahinde spinal blok, siyatik-femoral blok, sevofluran ve desfluran anestezi uygulamasının kan ve snovial dokudaki MDA ve NO sevilerini değerlendirmektir. GEREÇ VE YÖNTEMLER: Çalışmaya ASA I-II 60 erişkin hasta dahil edilerek turnike altında artroskopik cerrahi geiçrecek hastalar drt gruba ayrıldı. Hastalara siyatik-femoral blokaj (Grup I) ve spinal blok (Grup II) uygulandı. Genel anestezi uygulaması sırasıyla sevofluran (Grup III) ve desfluran (Grup IV) ile gerçekleştirildi. Anestezi öncesi (T1), turnike açılmadan 1 dk. önce (T2), turnike açıldıktan 5 dk. sonra (T3) ve turnike açıldıktan 20 dk. sonra (T4) kan örnekleri alındı. Ek olarak T2. ve T3. evrelerde cerrahi alandan snovial doku örnekleri alındı.BULGULAR:Çalışmamızda tüm gruplardaki MDA düzeyleri T3 evresinde, T1 evresine göre anlamlı artış göstermiştir. Ek olarak, Grup I ve IV'de T4 evresindeki plazma MDA düzeyleri T1 evresine göre anlamlı artış göstermiştir. Tüm gruplardaki plazma NO düzeyleri T2, T3 ve T4 evrelerinde; T1 evresine göre anlamlı artış göstermiştir. Doku NO düzeyleri, Grup I'de en belirgin olmak üzere artmıştır. SONUÇ: Çalışmamızda artroskopik cerrahide turnike uygulaması sonrasında geçici nötrofil aktivasyonu ve transendotelial nötrofil migrasyonu gösterilmiştir. Turnike kullanımına bağlı iskemi reperfüzyon hasarında spinal blok ve sevofluran ile anestezisi uygulamasının desfluran ve siyatik-femoral blok tekniğine göre tercih edilmesi gerektiği sonucuna varıldı

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

ARTROSKOPİK DİZ CERRAHİSİNDE TURNİKE UYGULAMASINA BAĞLI İSKEMİ REPERFÜZYON HASARINA İNHALASYON VE REJYONEL ANESTEZİ UYGULAMARININ ETKİLERİ

Öz:

OBJECTIVE: The application of a tourniquet for knee surgery is often used to improve exposure operative field. However, the release of tourniquet causes an ischemia/reperfusion injury. The aim of the study was to investigate the effect of spinal blockade and sciatic-femoral somatic blockade, sevoflurane and desflurane anaesthesia, on oxidative stress by determining malondialdehyde (MDA) and nitric oxide (NO) levels in blood and synovial tissue during arthroscopic knee surgery under a tourniquet. MATERIAL AND METHODS: We studied 60 adult ASA I-II patients undergoing arthroscopic knee surgery under a tourniquet were divided into four groups. It was performed sciatic-femoral blockade in Group I and spinal anaesthesia in Group II. General anaesthesia was used with sevoflurane and desflurane, in Group III and Group IV respectively. Venous blood samples were obtained before anaesthesia (T1), 1 min before tourniquet release (T2), 5 min after tourniquet release (T3) and 20 min after tourniquet release (T4). In addition synovial membrane tissue samples were obtained the periods of T2 and T3. RESULTS: Plasma concentrations of MDA increased significantly in all groups at T3 value compared with the T1 value. In addition 20 min after reperfusion (T4) plasma MDA levels were significantly increase than T1 period in Group I and IV. The tissue MDA levels were higher than ischemia in all groups the early reperfusion periods. The NO levels were significantly increased at the T2, T3 and T4 periods compared to T1 in all groups. There was a significant increase in tissue NO in Group I. CONCLUSION: According to our results showed that temporary neutrophil activation and transendothelial neutrophil migration during during arthroscopic knee surgery under a tourniquet. Spinal block and sevoflurane anaesthesia may be preferred to desflurane anesthesia and sciatic-femoral block techniques usage in cases where ischemia-reperfusion is created in the extremities

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KAYMAK C, ÇETİK Ö, ÇAKIRCA M, ÇAĞLAYAN O, APAN A (2015). THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. , 5 - 12.
Chicago	KAYMAK CETİN,ÇETİK Özgür,ÇAKIRCA Mehmet,ÇAĞLAYAN Osman,APAN Alpaslan THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. (2015): 5 - 12.
MLA	KAYMAK CETİN,ÇETİK Özgür,ÇAKIRCA Mehmet,ÇAĞLAYAN Osman,APAN Alpaslan THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. , 2015, ss.5 - 12.
AMA	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. . 2015; 5 - 12.
Vancouver	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. . 2015; 5 - 12.
IEEE	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A "THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET." , ss.5 - 12, 2015.
ISNAD	KAYMAK, CETİN vd. "THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET". (2015), 5-12.

APA	KAYMAK C, ÇETİK Ö, ÇAKIRCA M, ÇAĞLAYAN O, APAN A (2015). THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 48(1), 5 - 12.
Chicago	KAYMAK CETİN,ÇETİK Özgür,ÇAKIRCA Mehmet,ÇAĞLAYAN Osman,APAN Alpaslan THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 48, no.1 (2015): 5 - 12.
MLA	KAYMAK CETİN,ÇETİK Özgür,ÇAKIRCA Mehmet,ÇAĞLAYAN Osman,APAN Alpaslan THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, vol.48, no.1, 2015, ss.5 - 12.
AMA	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2015; 48(1): 5 - 12.
Vancouver	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2015; 48(1): 5 - 12.
IEEE	KAYMAK C,ÇETİK Ö,ÇAKIRCA M,ÇAĞLAYAN O,APAN A "THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET." Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 48, ss.5 - 12, 2015.
ISNAD	KAYMAK, CETİN vd. "THE EVALUATION OF ISCHEMIA/REPERFUSION INJURY ON REGIONAL AND INHALATION ANAESTHESIA DURING ARTHROSCOPIC KNEE SURGERY UNDER A TOURNIQUET". Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 48/1 (2015), 5-12.