BACKGROUND:Ischemia-reperfusion (I/R) may worsen blood rheology that has been demonstrated by clinical and experimental data. It is also known that anti-inflammatory agents and preconditioning methods may reduce I/R injury. OBJECTIVE:We aimed to analyze hemorheological alterations in elective kneeoperations and the effects of intraoperative nonsteroidal anti-inflammatory drug (NSAID) administration and application of ischemic preconditioning. METHODS:Hemorheological variables of 17 patients with total knee replacement or anterior crucial ligament replacement were analyzed. The ischemic (tourniquet) time was 92±15 minutes. Seven patients did not receive NSAID (Control group), 5 patients got i.v. sodium-diclophenac 10 minutes before and 6 hours after reperfusion. Five patients had ischemic preconditioning (3×15 minutes). Blood samples were collected before the ischemia, 10 minutes after reperfusion, on the 1st and 2nd p.o. day. RESULTS:Whole blood viscosity didn’t show notable inter-group differences, except for a slight decrease in the preconditioning group. RBC deformability decreased, erythrocyte aggregation enhanced by the 1st and 2nd p.o. days in Control group. In NSAID and preconditioning groups the changes were moderate, aggregation values significantly lowered compared to the Control group. CONCLUSION:Intraoperatively administered diclophenac or ischemic preconditioning could moderate the deterioration in micro-rheological parameters caused by I/R in patients.

中文翻译：

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术中给予双氯芬酸或缺血预处理对下肢手术患者术后微流变学的有益影响——初步数据

背景：缺血再灌注 (I/R) 可能会恶化血液流变学，临床和实验数据已证明这一点。还已知抗炎剂和预处理方法可以减少 I/R 损伤。目的：我们旨在分析择期膝关节手术的血液流变学改变以及术中使用非甾体抗炎药（NSAID）和应用缺血预处理的效果。方法：对17例全膝关节置换术或前关键韧带置换术患者的血液流变学指标进行分析。缺血（止血带）时间为 92±15 分钟。7 名患者未接受 NSAID（对照组），5 名患者在再灌注前 10 分钟和再灌注后 6 小时静脉注射双氯酚酸钠。5 名患者进行了缺血预处理（3×15 分钟）。在局部缺血前、再灌注后 10 分钟、给药第 1 天和第 2 天采集血样。结果：全血粘度没有显着组间差异，除了预处理组略有下降。对照组的红细胞变形能力下降，红细胞聚集在第 1 天和第 2 天增加。在 NSAID 和预处理组中，变化是中等的，与对照组相比，聚集值显着降低。结论：术中给予双氯芬酸或缺血预处理可缓解因 I/R 引起的患者微流变学参数的恶化。除了预处理组略有下降。对照组的红细胞变形能力下降，红细胞聚集在第 1 天和第 2 天增加。在 NSAID 和预处理组中，变化是中等的，与对照组相比，聚集值显着降低。结论：术中给予双氯芬酸或缺血预处理可缓解因 I/R 引起的患者微流变学参数的恶化。除了预处理组略有下降。对照组的红细胞变形能力下降，红细胞聚集在第 1 天和第 2 天增加。在 NSAID 和预处理组中，变化是中等的，与对照组相比，聚集值显着降低。结论：术中给予双氯芬酸或缺血预处理可缓解因 I/R 引起的患者微流变学参数的恶化。