Journal de la douleur et du soulagement

Abstrait

The Effect of Oral Melatonin Premedication on Pneumatic Tourniquet Induced Ischemia Reperfusion Injury in Lower Extremity Operations

Tuba Berra Saritas*, Sadik Buyukbas, Kevser Peker, Hale Borazan, Kemal Basarali, Ibrahim Tuncay, Alper Kiliçarslan and Seref Otelcioglu

Purpose: Melatonin is a well-known antioxidant molecule and protector against ischemia reperfusion (I/R) injury. It has a tissue protective effect against I/R injury. Methods: We aimed to evaluate the effect of oral melatonin, on I/R injury in patients undergoing arthroscopic knee surgery under spinal anaesthesia.

Methods: Malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), haemodynamics, respiration rate, atropine and efedrin need, sedation scores were all measured for this purpose.

New Results: There were no significant differences between groups in terms of age, weight, height, sex, ASA classification, BMI, tourniquet time and operation time. Plasma concentrations of MDA increased after ischemia (AI) and decreased at the 15 min of reperfusion (AR) but these results are not statistically significant (p>0.05). Plasma NO levels of Group C were significantly increased when compared to baseline values and Group M at AI period. It decreased significantly in both of the groups AR. Plasma SOD levels in preischemia period increased significantly in both of the groups. Also decreased significantly compared to AI period, and increased significantly compared to basal values in both of the groups.

Conclusions: In conclusion 3 mg oral melatonin does not reduce I/R injury in skeletal muscle after pneumatic tourniquet application in human. It may reduce I/R injury in skeletal muscle in higher doses. So future investigation may be necessary to clarify if melatonin decreases I/R injury model of human skeletal muscle and at what dose or not.