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Effects of acetylcysteine and ischaemic preconditioning on muscular function and postoperative pain after orthopaedic surgery using a pneumatic tourniquet.
Orban, J-C; Levraut, J; Gindre, S; Deroche, D; Schlatterer, B; Ichai, C; Grimaud, D.
Afiliación
  • Orban JC; Hôpital Saint-Roch, Département d'Anesthésie-Réanimation Est, Nice, France. orban.j@chu-nice.fr
Eur J Anaesthesiol ; 23(12): 1025-30, 2006 Dec.
Article en En | MEDLINE | ID: mdl-16780616
BACKGROUND AND OBJECTIVE: The use of a pneumatic tourniquet can induce muscular and neurological complications in the operated limb. The genesis of these injuries could involve an ischaemia/reperfusion phenomenon and a compression under the cuff. We evaluated effects of an antioxidant, acetylcysteine and ischaemic preconditioning on the rhabdomyolysis and postoperative pain following a knee ligamentoplasty using a pneumatic tourniquet. METHODS: We included 31 patients scheduled for a knee ligamentoplasty randomly assigned in three groups (control, acetylcysteine 1200 mg the day before and 600 mg at the operative day, ischaemic preconditioning). RESULTS: There was a moderate rise in myoglobin and creatinine phosphokinase with no significant difference between the three groups. The muscular functional parameters were similar in all the groups. However, the morphine consumption within the first 48 h was smaller in the treatment groups (0.22 +/- 0.31 mg kg-1 and 0.22 +/- 0.23 mg kg-1 in the preconditioning and antioxidant groups, respectively) than in the control group (0.47 +/- 0.33 mg kg-1, P <0.05). CONCLUSIONS: Acetylcysteine and ischaemic preconditioning do not decrease the extent of rhabdomyolysis related to the use of a pneumatic tourniquet and do not improve the postoperative muscle recovery. On the other hand, they allow a significant reduction in the postoperative morphine consumption.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Acetilcisteína / Torniquetes / Precondicionamiento Isquémico / Procedimientos Ortopédicos Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Anaesthesiol Asunto de la revista: ANESTESIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Acetilcisteína / Torniquetes / Precondicionamiento Isquémico / Procedimientos Ortopédicos Tipo de estudio: Clinical_trials / Etiology_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Anaesthesiol Asunto de la revista: ANESTESIOLOGIA Año: 2006 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido