Open Journal of Anesthesiology, 2021, 11, 12-24
https://www.scirp.org/journal/ojanes
ISSN Online: 2164-5558
ISSN Print: 2164-5531
DOI: 10.4236/ojanes.2021.111002 Jan. 20, 2021 12 Open Journal of Anesthesiology
Effect of Intravenous Ibuprofen on
Ischemia-Reperfusion Injury Following
Perioperative Tourniquet in Patients
Undergoing Total Knee Arthroplasty
T. Dulkadiroğlu
1
, Ş. M. Aksoy
1
, G. Uğur
2
, E. Erkılıç
2
, A. D. Özcan
2
, S. Erdoğan
2
, A. But
1
, C. Nural
2
,
O. Tecimel
2
, H. Kara
1
1
Department of Anesthesiology, Faculty of Medicine, University of Yıldırım Beyazıt, Ankara, Turkey
2
Department of Anesthesiology, Ankara City Hospital, Ankara, Turkey
Abstract
Oxidative stress occurs in the organism with ischemia due to tourniquet use
and subsequent reperfusion. Oxidative stress increases postoperative morbid-
ity. Some Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) perform their
anti-inflammatory effects in part by binding or inhibiting their formation of
active oxygen radicals at the site of inflammation. In this study, we aimed to
evaluate the effect of IV ibuprofen on ischemia-reperfusion injury (IRI) in
patients undergoing total knee arthroplasty over oxidative stress parameters.
The patients were randomly divided into two groups. Each patient’s protocol
number, age, sex, body mass index (BMI), additional disease, drug use, tour-
niquet time, hemoglobin value, additional analgesic requirement and applica-
tion, adverse reaction development on the first postoperative day were rec-
orded in the research follow-up form. Both groups of patients; before anes-
thesia, 45 minutes after tourniquet application, 5 minutes after tourniquet
lowering, 20 minutes after tourniquet lowering and at 24th-hour post-op;
TOS, TAS, paraoxonase, arylesterase, myeloperoxidase, catalase, ceruloplas-
min, albumin, IMA, thiol-disulfide balance tests were studied. Statistical
analysis of test results was performed. We observed that antioxidants de-
creased and oxidants increased on the first postoperative day in both groups
in patients who underwent total knee arthroplasty. The decrease in antioxi-
dant parameters was higher in IV ibuprofen doses compared to the control
group in the case group; these doses indicate that the drug adversely affects
the organism in the fight against oxidative stress, which is an undesirable ef-
fect. To evaluate this negative effect of IV ibuprofen which is increasingly
How to cite this paper: Dulkadiroğlu, T.,
Aksoy, Ş.M., Uğur, G., Erkılıç, E., Özcan,
A.D., Erdoğan, S., But, A., Nural, C., Teci-
mel, O. and Kara, H. (2021) Effect of Intra-
venous Ibuprofen on Ischemia-Reperfusion
Injury Following Perioperative Tourniquet
in Patients Undergoing Total Knee Arth-
roplasty. Open Journal of Anesthesiology,
11, 12-24.
https://doi.org/10.4236/ojanes.2021.111002
Received: November 11, 2020
Accepted: January 17, 2021
Published: January 20, 2021
Copyright © 2021 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access