International Journal of Medical Sciences

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2.399

19 October 2017

ISSN 1449-1907 News feeds of published articles

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Int J Med Sci 2017; 14(2):115-122. doi:10.7150/ijms.17227

Research Paper

Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty

Chung-Sik Oh1, Seong-Hyop Kim1,2, Jaemoon Lee1, Ka Young Rhee1,2 ✉

1. Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea;
2. Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.

Abstract

Background: Ischaemic reperfusion injury (IRI) after tourniquet release during total knee arthroplasty (TKR) is related to postoperative cerebral complications. Remote ischaemic preconditioning (RIPC) is known to minimise IRI in previous studies. Thus, we evaluated the effect of RIPC on regional cerebral oxygenation after tourniquet release during TKR.

Methods: Patients undergoing TKR were randomly allocated to not receive RIPC (control group) and to receive RIPC (RIPC group). Regional cerebral oxygenation and pulmonary oxygenation were assessed up to 24 h postoperatively. The changes in serum cytokine and lactate dehydrogenase (LDH) levels were assessed and arterial blood gas analysis was performed. Total transfusion amounts and postoperative bleeding were also examined.

Results: In total, 72 patients were included in the final analysis. Regional cerebral oxygenation (P < 0.001 in the left side, P = 0.003 in the right side) with pulmonary oxygenation (P = 0.001) was significantly higher in the RIPC group. The serum LDH was significantly lower in the RIPC group at 1 h and 24 h postoperatively (P < 0.001). The 24 h postoperative transfusion (P = 0.002) and bleeding amount (P < 0.001) were significantly lower in the RIPC group.

Conclusions: RIPC increased cerebral oxygenation after tourniquet release during TKR by improving pulmonary oxygenation. Additionally, RIPC decreased the transfusion and bleeding amount with the serum LDH level.

Keywords: Cerebral oxygenation, Ischaemic reperfusion injury, Remote ischaemic preconditioning, Total knee arthroplasty.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Oh CS, Kim SH, Lee J, Rhee KY. Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty. Int J Med Sci 2017; 14(2):115-122. doi:10.7150/ijms.17227. Available from http://www.medsci.org/v14p0115.htm