The aim of this study was to compare the effects of propofol and N-acetyl cysteine (NAC) on tourniquet-induced ischaemia-reperfusion injury by determining malonyldialdehyde, ischaemia-modified albumin, lactate, blood gas and haemodynamic levels in arthroscopic knee surgery. Sixty ASA I or II patients were randomized into three groups. Intrathecal anaesthesia was administered using 0.5% heavy bupivacaine in all patients. In group P, propofol was administered in a 0.2 mg kg(-1) bolus, followed by infusion at a rate of 2 mg kg(-1) h(-1); in group NAC, NAC was administered as an infusion at a rate of 5 mg kg(-1) h(-1), and, in group C (the control group), an equal volume of isotonic saline was administered to patients until 30 min after reperfusion. Blood samplings were obtained immediately before intrathecal anaesthesia (t1), 1 min before tourniquet release (t2), 5 min after tourniquet release (t3) and 30 min after tourniquet release (t4). Plasma malonyldialdehyde, ischaemia-modified albumin and lactate levels increased significantly in group C at t3 and t4 compared with the baseline values. Plasma concentrations of malonyldialdehyde, ischaemia-modified albumin and lactate in groups P and NAC were significantly lower than those in group C at t3 and t4. In blood gas analyses, pH, HCO3 and base excess were found to be significantly lower at t3 and t4 compared with t1 and t2 in group C. Comparisons between groups P and NAC revealed no significant differences. Small-dose infusions of both propofol and NAC appear to provide similar protection against ischaemia-reperfusion injury in arthroscopic knee surgery.

Our aim in this study was to investigate the effect of levobupivacaine and a levobupivacaine + tramadol combination on postoperative analgesia in intraoperative nerve block under standard general anesthetic. Forty-five patients undergoing outpatient nasal surgery under general anesthesia were randomized into 3 groups. Group L: 0.25% levobupivacaine, group T: 0.25% levobupivacaine and 50 mg tramadol, group S: normal saline solution; 2 mL of each being injected into the infraorbital foramen. Intraoperative hemodynamic changes were recorded. Verbal numeric rating scale (NRS) values were checked at 30 minutes and 1, 2, 8, and 12 hours postoperatively, and the need for rescue analgesic treatment in the first 12 hours of all patients was recorded. Also antiemetic drug requirement and side effects (nausea, edema, erythema, hematoma, and sedation) were recorded. At 30 minutes and 1 hour postoperatively, NRS pain scores were lower in group T than in group S (P < 0.0001, P = 0.01, respectively). NRS pain score was lower in group T compared with group L at 1 hour postoperatively (P = 0.01). Effective analgesia time (sec) in the control group (142.67 ± 77.31) was shorter than levobupivacaine (240 ± 96.39) and levobupivacaine added to tramadol groups (277 ± 11.60) (P < 0.05). Additional analgesic requirement in the control group was higher than the other 2 groups in early postoperative period (P < 0.05). Bilateral infraorbital nerve block with 0.25% levobupivacaine is an effective, reliable, and simple technique in the treatment of postoperative pain in nasal surgery. In addition, the addition of tramadol as an adjuvant to local anesthetics in this technique is safe.

Background. The aim of this study is to compare the effects of sevoflurane and propofol on one lung ventilation (OLV) induced ischemia-reperfusion injury (IRI) by determining the blood gas, ischemia-modified albumin (IMA), and malonyldialdehyde (MDA).Material and Methods. Forty-four patients undergoing thoracic surgery with OLV were randomized in two groups (sevoflurane Group S, propofol Group P). Anesthesia was inducted with thiopental and was maintained with 1–2.5% of sevoflurane within the 40/60% of O₂/N₂O mixture in Group S. In Group P anesthesia was inducted with propofol and was maintained with infusion of propofol and remifentanil. Hemodynamic records and blood samples were obtained before anesthesia induction (t1), 1 min before two lung ventilation (t2), 30 min after two lung ventilation (t3), and postoperative sixth hours (t4).Results. Heart rate att2andt3in Group P was significantly lower than that in Group S. While there were no significant differences in terms of pH and pCO₂, pO₂att2andt3in Group S was significantly lower than that in Group P. IMA levels att4in Group S were significantly lower than those in Group P.Conclusion. Sevoflurane may offer protection against IRI after OLV in thoracic surgery.

Ischemia-reperfusion injury (IRI) is induced as a result of reentry of the blood and oxygen to ischemic tissue. Antioxidant and some other drugs have protective effect on IRI. In many surgeries and clinical conditions IRI is counteract inevitable. Some anesthetic agents may have a protective role in this procedure. It is known that inhalational anesthetics possess protective effects against IRI. In this review the mechanism of preventive effects of volatile anesthetics and different ischemia-reperfusion models are discussed.