The Role of Preconditioning and N-Acetylcysteine on Oxidative Stress Resulting From Tourniquet-Induced Ischemia-Reperfusion in Arthroscopic Knee Surgery

Koca, Kenan; Yurttaş, Yüksel; Çaycı, Tuncer; Bïlgïç, Serkan; Kaldirim, Umit; Durusu, Murat; Çekli, Yavuz; Özkan, Hüseyin; Hancı, Volkan; Purtuloglu, Tarik; Akgül, Emin Özgür; Oğuz, Erbil; Yıldız, Cemil; Basbozkurt, Mustafa

doi:10.1097/ta.0b013e3181f30fb0

Cited by 40 publications

(40 citation statements)

References 48 publications

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“…Silymarin significantly enhanced SOD and GPX levels and decreased hs-CRP compared to the control. TAC levels as an indicator of the overall protective effect of antioxidants in body fluids, on cell membranes and other components of cells against oxidative damage (Koca et al 2011) were elevated in the silymarin supplementation group compared to the placebo. Additionally, a significant decrease was observed in serum levels of MDA in the silymarin group compared to the baseline.…”

Section: Discussionmentioning

confidence: 87%

Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: A randomized, triple-blind, placebo-controlled clinical trial

et al. 2015

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Section: Discussionmentioning

confidence: 87%

Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: A randomized, triple-blind, placebo-controlled clinical trial

et al. 2015

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“…Interestingly, muscle mitochondrial dysfunction was recently shown to be associated with 5-year survival in patients with peripheral arterial disease, underlining its clinical significance [11]. Ischemic preconditioning (i.e., short bouts of nondamaging periods of ischemia and reperfusion before long-lasting index ischemia) provides muscular protection with improved mitochondrial function and decreased oxidative stress in young animals [12] or young healthy patients [13].…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle ischemia–reperfusion injury and cyclosporine A in the aging rat

Pottecher

Kindo

Chamaraux-Tran

et al. 2016

Fundamemntal Clinical Pharma

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Old patients exhibit muscle impairments and increased perioperative risk during vascular surgery procedures. Although aging generally impairs protective mechanisms, data are lacking concerning skeletal muscle in elderly. We tested whether cyclosporine A (CsA), which protects skeletal muscle from ischemia-reperfusion (IR) in young rats, might reduce skeletal muscle mitochondrial dysfunction and oxidative stress in aging rats submitted to hindlimb IR. Wistar rats aged 71-73 weeks were randomized to IR (3 h unilateral tourniquet application and 2 h reperfusion) or IR + CsA (10 mg/kg cyclosporine IV before reperfusion). Maximal oxidative capacity (VM ax ), acceptor control ratio (ACR), and relative contribution of the mitochondrial respiratory chain complexes II, III, IV (VS ucc ), and IV (VTMPD /Asc ), together with calcium retention capacity (CRC) a marker of apoptosis, and tissue reactive oxygen species (ROS) production were determined in gastrocnemius muscles from both hindlimbs. Compared to the nonischemic hindlimb, IR significantly reduced mitochondrial coupling, VMax (from 7.34 ± 1.50 to 2.87 ± 1.22 μMO2 /min/g; P < 0.05; -70%), and VS ucc (from 6.14 ± 1.07 to 3.82 ± 0.83 μMO2 /min/g; P < 0.05; -42%) but not VTMPD /Asc . IR also decreased the CRC from 15.58 ± 3.85 to 6.19 ± 0.86 μMCa(2+) /min/g; P < 0.05; -42%). These alterations were not corrected by CsA (-77%, -49%, and -32% after IR for VM ax, VS ucc , and CRC, respectively). Further, CsA significantly increased ROS production in both hindlimbs (P < 0.05; +73%). In old rats, hindlimb IR impairs skeletal muscle mitochondrial function and increases oxidative stress. Cyclosporine A did not show protective effects.

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“…One study used both anaesthetic and antioxidant intervention (propofol and N‐acetyl‐cysteine) (Table ). Three studies used ischaemic pre‐conditioning (Table ) and one study used both ischaemic pre‐conditioning and antioxidant intervention (N‐acetyl‐cysteine) (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…One study examined both propofol and N‐acetyl‐cysteine, but propofol was used in a sub‐anaesthetic dose and we therefore categorised it in the antioxidant intervention group . In one study that both used antioxidant intervention (N‐acetyl‐cysteine) and ischaemic pre‐conditioning, the authors found that ischaemic pre‐conditioning was superior to N‐acetyl‐cysteine in protecting against ischaemia–reperfusion injuries; we therefore chose to categorise this study in the ischaemic pre‐conditioning group (Table ). It will, however, also be briefly described in this section.…”

Section: Resultsmentioning

confidence: 99%

Interventions to reduce tourniquet‐related ischaemic damage in orthopaedic surgery: a qualitative systematic review of randomised trials

et al. 2014

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SummaryIschaemia of the extremity from the use of a tourniquet and the subsequent reperfusion contribute to the release of reactive oxygen species. This release may result in injury to remote organs. We performed a qualitative systematic review exploring the interventions used to prevent tourniquet-related oxidative damage in adults undergoing orthopaedic surgery, and the possible relationship between biochemical oxidative stress markers and postoperative clinical outcomes. Seventeen randomised controlled studies were included in the qualitative synthesis. Most trials were of low methodological quality and only two studies reported postoperative clinical outcomes. Nine studies tested anaesthetics (propofol, dexmedetomidine, ketamine, and spinal anaesthesia); four studies tested antioxidants (N-acetylcysteine, vitamin C, and mannitol); and four studies tested ischaemic pre-conditioning. Fifteen studies showed a significant reduction in biochemical oxidative stress markers. We conclude that propofol and ischaemic preconditioning, in particular, appear to show some benefit at reducing oxidative stress following operations under tourniquet; the correlation between a reduction in oxidative stress and postoperative clinical outcomes should be further investigated in the future.

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The Role of Preconditioning and N-Acetylcysteine on Oxidative Stress Resulting From Tourniquet-Induced Ischemia-Reperfusion in Arthroscopic Knee Surgery

Cited by 40 publications

References 48 publications

Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: A randomized, triple-blind, placebo-controlled clinical trial

Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: A randomized, triple-blind, placebo-controlled clinical trial

Skeletal muscle ischemia–reperfusion injury and cyclosporine A in the aging rat

Interventions to reduce tourniquet‐related ischaemic damage in orthopaedic surgery: a qualitative systematic review of randomised trials

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