The effects of axillary nerve block and intravenous regional anesthesia on ischemia-reperfusion injury induced by tourniquet Aksiller sinir bloğu ve İntravenöz rejyonal anestezinin turnike sonucu gelişen İskemi-reperfüzyon hasarına etkileri


TUĞCUGİL E. , KUTANİS D. , BEŞİR A. , KOŞUCU M. , MENTEŞE A. , KARAHAN S. C. , ...More

Anestezi Dergisi, vol.28, no.2, pp.100-108, 2020 (Refereed Journals of Other Institutions) identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 2
  • Publication Date: 2020
  • Doi Number: 10.5222/jarss.2020.39974
  • Title of Journal : Anestezi Dergisi
  • Page Numbers: pp.100-108
  • Keywords: Axillary nerve block, Intravenous regional anesthesia, Ischemia reperfusion, Oxidative stress

Abstract

© Copyright Anesthesiology and Reanimation Specialists’ Society.Objective: We aimed to compare the effects of axillary nerve block and IVRA (Intravenous Regional Anesthesia) techniques used in patients planned to undergo hand surgery on tourniquet induced ischemia- reperfusion injury. Ischemia due to the use of tourniquet and the subsequent reperfusion cause oxidative stress in the organism. Oxidative stress contributes to postoperative morbidity. Method: The study included 65 patients who underwent hand surgery. The patients received axillary nerve block were assigned to Group A (n=33) and the patients received IVRA were assigned to Group I (n=32). Blood samples were collected at T1 before anesthesia, T2 immediately before tourniquet deflation, T3 5 min, T4 30 min and T5 4 hours after tourniquet deflation and serum TAS (total antioxidant level), TOS (total oxidant level), OSI (oxidant status index) and IMA (ischemia modified albümin) levels were studied. Results: Plasma concentration of IMA and OSI were significantly higher in Group A than in Group I at T2, T3, T4 time points. Plasma TOS level was higher in Group A than in Group I at time point T3. Plasma TAS level was significantly higher in Group I than in Group A at time points of T2, T3, T4. Conclusion: IVRA was more effective than axillary block in preventing ischemia- reperfusion injury induced by tourniquet used in hand surgery, but there was no difference between these two techniques in the fourth hour of reperfusion.