Effect of Intravenous Ibuprofen on Ischemia-Reperfusion Injury Following Perioperative Tourniquet in Patients Undergoing Total Knee Arthroplasty

Abstract

Oxidative stress occurs in the organism with ischemia due to tourniquet use and subsequent reperfusion. Oxidative stress increases postoperative morbidity. Some Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) perform their anti-inflammatory effects in part by binding or inhibiting their formation of active oxygen radicals at the site of inflammation. In this study, we aimed to evaluate the effect of IV ibuprofen on ischemia-reperfusion injury (IRI) in patients undergoing total knee arthroplasty over oxidative stress parameters. The patients were randomly divided into two groups. Each patient's protocol number, age, sex, body mass index (BMI), additional disease, drug use, tourniquet time, hemoglobin value, additional analgesic requirement and application, adverse reaction development on the first postoperative day were recorded in the research follow-up form. Both groups of patients; before anesthesia, 45 minutes after tourniquet application, 5 minutes after tourniquet lowering, 20 minutes after tourniquet lowering and at 24th-hour post-op; TOS, TAS, paraoxonase, arylesterase, myeloperoxidase, catalase, ceruloplasmin, albumin, IMA, thiol-disulfide balance tests were studied. Statistical analysis of test results was performed. We observed that antioxidants decreased and oxidants increased on the first postoperative day in both groups in patients who underwent total knee arthroplasty. The decrease in antioxidant parameters was higher in IV ibuprofen doses compared to the control group in the case group; these doses indicate that the drug adversely affects the organism in the fight against oxidative stress, which is an undesirable effect. To evaluate this negative effect of IV ibuprofen which

The effects of pre‐emptive intravenous ibuprofen on the thiol/disulfide homeostasis and C‐reactive protein level as the markers of oxidative stress and inflammation during gynecologic laparoscopy: A randomised clinical trial

“…This indicated that the drug adversely affected the organism to fight oxidative stress and it should be taken into account in the drug choice for postoperative analgesia. 18 Similar to this study, the NT and TT levels were significantly decreased in ibuprofen pretreated patients in our study. However, no significant change was recorded in terms of disulfide level in all measurement points.…”

“…Despite the NT and TT values were significantly decreased in this study, thiol/disulfide, disulfide/ NT, and disulfide/total levels showed no significant changes. This indicated that the drug adversely affected the organism to fight oxidative stress and it should be taken into account in the drug choice for postoperative analgesia 18 . Similar to this study, the NT and TT levels were significantly decreased in ibuprofen pretreated patients in our study.…”