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

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 (t1), 30 min after tourniquet inflation (t2), immediately before (t3), and 5 min (t4), 15 min (t5), 30 min (t6), 1 h (t7), 2 h (t8), and 6 h (t9) after tourniquet release.Results. MDA and IMA levels increased significantly compared with baseline values in Group S att2–t9andt2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S att2–t8andt2–t9. IMA levels in Group T were significantly lower than those in Group S att2–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.