The effect of vitamin C on hemodynamics and arterial blood gas in tourniquet induced ischemia-reperfusion injury during unilateral total knee replacement in elderly patients

Kim, Chang Jae; Chung, Mee Young

Clinical Research

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2008;3(4):277-281.
Published online October 30, 2008.

The effect of vitamin C on hemodynamics and arterial blood gas in tourniquet induced ischemia-reperfusion injury during unilateral total knee replacement in elderly patients

Chang Jae Kim, Mee Young Chung

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. jhjs0806@catholic.ac.kr

Abstract

BACKGROUND
Free radicals, such as reactive oxygen species which are released abruptly after deflation of an ischemic tourniquet, cause reperfusion injuries. Vitamin C produce cytoprotective effects due to reduction of free radicals. This study was designed to investigate the effect of vitamin C on hemodynamics and arterial blood gas during unilateral total knee replacement. METHODS: In the vitamin C group (VC group: N = 19), patients were administrated with vitamin C:a priming bolus of vitamin C 0.06 g/kg mixed with 100 ml saline infused for 20 min at 10 min before deflation of tourniquet, followed by vitamin C 0.02 g/kg mixed with 30 ml saline at 0.5 ml/min. In the control group (control group: N = 15), patients were infused by 100 ml saline. Mean arterial blood pressure, heart rate and arterial blood gas were measured at 20 min after anesthesia induction, just before deflation, 5 min after deflation and 20 min after deflation of tourniquet. RESULTS: Mean arterial blood pressure in the VC group was maintained higher than control group at 1 min after deflation of the tourniquet. Arterial O2 tension and saturation in the VC group were higher than control group at 5 min and 20 min after deflation of the tourniquet. CONCLUSIONS: We concluded that the administration of vitamin C during total knee replacement could inhibit decline of mean arterial blood pressure and arterial oxygenation induced by ischemiareperfusion significantly.

Key Words: arterial blood gas, ischemic-reperfusion injury, total knee replacement, vitamin C