The clinical importance of vitamin e for tourniquet ischemia during total knee arthroplasty

Purpose: This study was perfomed to investigate whether the intramuscular injection of vitamin E is efffective or not in tourniquet-induced ischemia and reperfusion injury during total knee arthroplasty Methods: 51 patients undergoing elective total knee replacement surgery with tourniquet were studied. Patients divided into two groups. Vitamin E was administered to group I/R+E. Demographic data, operation and tourniquet time was recorded. Blood samples were taken three times in EDTA tubes which include before induction of anesthesia (T0), 1 minute before tourniquet deflation (T1) and 20 minutes after tourniquet deflation(T2). We analyzed malondealdehid which was a product of the lipid peroxidation, the glutathione which was an antioxidant substance, nitric oxide and xanthine oxidase in these blood samples. Results: We found statistical differences between I/R group and I/R+E group on XOD and GSH levels before induction of anesthesia (T0), 1 minute before tourniquet deflation (T1) and 20 minutes after tourniquet deflation(T2). XOD and GSH levels were significantly higher in I/R+E group at all of the time periods. There were no significant differences in other parameters. Conclusion: In this study we showed that vitamin E increased levels of GSH and increased antioxidant activity. We can minimize complications of tourniquet by using vitamin E.