The Effect of Infraclavicular Block on Tourniquet-Induced Ischaemia Reperfusion Injury: A Prospective Randomized Controlled Study

BACKGROUND/AIMS: Ischemia-reperfusion injury (IRI) occurs due to the release of free oxygen radicals after tourniquet usage. Following tourniquet application, parameters such as ischemia modified albumin (IMA), total antioxidant status (TAS) and total oxidant status (TOS) become more frequently studied in order to reveal IRI. The aim of this study was to compare the effects of both infraclavicular block (ICB) and general anaesthesia (GA) on IRI in a prospective randomized controlled manner.MATERIALS AND METHODS: Sixty patients undergoing extremity surgery with tourniquet were randomized in two groups (the ICB group ICB and the GA group GA). In the group ICB, anaesthesia using USG linear probe was applied via a lateral-sagittal technique. Conversely, anaesthesia was inducted with propofol and was maintained with 2-3% sevoflurane, 50% O2/air mixture in the group GA. Blood samples were drawn before ICB and the induction of GA (T1), and again 2 hours after tourniquet opening (T2). Serum TAS, TOS and IMA levels were calculated using diagnostic kits.RESULTS: A total 47 patients were evaluated in both groups. There was no statistical significance within or between the two groups in terms of their IMA, TAS and TOS values at T1 and T2 (p>0.05). In addition, there was no statistical significance within or between either group in terms of IMA, TAS and TOS values according to their tourniquet times (0-60 and 61-120 min) (p>0.05).CONCLUSION: Infraclavicular nerve block and GA were not superior to each other in preventing IRI associated with a tourniquet duration of up to 120 min.