Purine metabolite washout and platelet aggregation at reflow after tourniquet ischemia: effect of intravenous regional lidocaine

Acta Anaesthesiologica Scandinavica
O NaeshI Hindberg

Abstract

Tourniquet ischemia will influence the biochemical milieu of tissue cells and affect the metabolism of purines in skeletal muscle distal to the occlusion. At reperfusion, generation of oxygen radicals by the hypoxanthine-xanthine oxidase system may ensue, influencing white blood cell and thrombocyte aggregation, causing damage to the endothelial cell barrier and inducing non-reflow type phenomena. Amide-type local anaesthetics are known to affect local vasotone, leukocyte adherence and platelet function but the influence of lidocaine on purine metabolite washout and platelet aggregation following tourniquet ischemia for lower limb surgery is not known in detail. Therefore, the effects of regional intravenous lidocaine during tourniquet ischemia for knee surgery on purine catabolite washout and platelet function following reflow were assessed. Eight patients served as control (C-group) and 8 (L-group) received 100 ml of lidocaine (2.5 mg/ml) in the emptied venous bed of the leg to be operated. All patients had spinal anaesthesia (0.5% bupivacaine). Effluent venous blood from the leg and radial arterial blood was collected and analysed for xanthine (X), hypoxanthine (HX), base excess (BE), pH and potassium before and after reperf...Continue Reading

References

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Citations

Feb 1, 1997·Acta Anaesthesiologica Scandinavica·Z J Koscielniak-Nielsen, L Hesselbjerg
Nov 13, 2013·The Spine Journal : Official Journal of the North American Spine Society·Kyoung-Tae KimGeun-Joo Choi
Feb 16, 2010·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·T O Smith, C B Hing
Feb 26, 2009·The Knee·Toby O Smith, Caroline B Hing
Aug 28, 1999·Annales Françaises D'anesthèsie Et De Rèanimation·J P Estèbe

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