Effect of etomidate on the oxidative stress response and levels of inflammatory factors from ischemia-reperfusion injury after tibial fracture surgery

Li,Renke; Fan,Lei; Ma,Fenglei; Cao,Yongyan; Gao,Junwei; Liu,Huawen; Li,Yan

doi:10.3892/etm.2017.4037

Effect of etomidate on the oxidative stress response and levels of inflammatory factors from ischemia-reperfusion injury after tibial fracture surgery

Authors:
- Renke Li
- Lei Fan
- Fenglei Ma
- Yongyan Cao
- Junwei Gao
- Huawen Liu
- Yan Li
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Affiliations: Department of Anesthesiology, Zhengzhou Orthopaedics Hospital, Zhengzhou, Henan 450000, P.R. China, Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan 450000, P.R. China, Department of Anesthesiology, Henan Provincial Chest Hospital, Zhengzhou, Henan 450000, P.R. China
Published online on: January 12, 2017 https://doi.org/10.3892/etm.2017.4037
Pages: 971-975
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The effect of etomidate on the oxidative stress response and levels of inflammatory factors resulting from ischemia‑reperfusion injury of the lower extremities during tibial fracture surgery were investigated. From December 2013 to June 2015, 60 tibial fracture patients with surgical indications for open reduction and internal fixation were selected. Patients were randomly divided into the observation group and the control group. All patients were stanched by tourniquet hemostasis. Patients in the observation group were anesthetized with etomidate (3-6 mg/kg·h) + remifentanil (0.1-0.25 µg/kg/min) administered with an injection pump to maintain intraoperative sedation and analgesia anesthesia. Patients in the control group received propofol (3-6 mg/kg·h) + remifentanil (0.1‑0.25 µg/kg/min). Before surgery (T0), before surgery was completed and anesthesia was stopped (T1), 24 h after surgery (T3), 48 h after surgery (T4), and 1 week after surgery (T5), serum superoxide dismutase (SOD) activity was determined with a kit, and ELISA was used to measure the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1, and IL-6 in peripheral blood from both groups of patients. Surgery in both groups was completed smoothly. We found that serum SOD levels of patients in the observation group were significantly higher than those of the control group, while the levels of TNF-α, IL-1, and IL-6 released by neutrophils were significantly decreased after ischemia‑reperfusion injury (P<0.05). Postoperative length of stay in hospital of the observation group was significantly shorter and the occurrence rate of anesthesia complications was significantly lower than in the control group (P<0.05). In conclusion, during surgery for lower limb fracture, the use of etomidate for maintaining sedation can effectively maintain serum SOD activity and inhibit the release of inflammatory factors after ischemia-reperfusion injury of the fracture, to reduce the occurrence rate of anesthesia complications after surgery.

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