Protection of pre-administration of Shengmai injection on ischemia-reperfusion injury of skeletal muscle in lower limb after knee joint replacement

doi:10.3969/j.issn.2095-4344.2016.53.002

Abstract

Abstract:

BACKGROUND: The use of tourniquets in limb surgery often leads to ischemia-reperfusion injury, and can cause important organ damage through inflammation. In recent years, Chinese herbal medicine prevention and treatment of skeletal muscle ischemia-reperfusion injury has made great progress, and its effective composition and mechanism of action can provide new treatment ideas for broadening the application areas.

OBJECTIVE: To investigate the protective mechanism of Shengmai injection pretreatment on knee arthroplasty to lower limb skeletal muscle ischemia-reperfusion.

METHODS: Sixty cases undergoing elective knee replacement surgery were equally and randomly divided into Shengmai injection group and control group. In the Shengmai injection group, Shengmai injection 1 mL/kg (100 mL diluted with normal saline) was intravenously injected 10 minutes before induction of anesthesia. In the control group, an equal volume of physiological saline was injected. Blood pressure, heart rate, arterial blood gas pH, PaCO₂, surgery time and tourniquet time were recorded before, during and after surgery. Serum tumor necrosis factor-α, interleukine-8, superoxide dismutase, and malondialdehyde levels were compared before tourniquet (T0), before tourniquet release (T1), and 1 hour of reperfusion (T2).
RESULTS AND CONCLUSION: (1) Preoperative, intraoperative and postoperative blood pressure, heart rate, pH and PaCO₂ were not significantly different between the Shengmai injection and control groups. In the control group, intraoperative blood pressure decreased, heart rate became slow, and carbon dioxide partial pressure increased, which were significantly lower than that before and after surgery, but pH, standard bicarbonate, and alkali residual value were gradually reduced (P < 0.05). Intraoperative blood pressure and heart rate were higher, but PaCO₂ were lower in the Shengmai injection group compared with the control group. Intraoperative and postoperative pH, standard bicarbonate, and alkali residual value were higher in the Shengmai injection group than in the control group (P < 0.05). (2) Operation time and tourniquet time were not significantly different between the two groups (P > 0.05). (3) At T0, T1 and T2, superoxide dismutase levels decreased, while malondialdehyde, tumor necrosis factor-α, and interleukine-8 levels gradually increased in the control group (P < 0.05). Each indicator was not significant in the Shengmai injection group. Compared with the control group, superoxide dismutase levels were significantly increased at T1 and T2, but malondialdehyde, tumor necrosis factor-α, and interleukine-8 levels significantly reduced in the Shengmai injection group (P < 0.05). (4) These results suggested that Shengmai injection with multi-target effects can improve microcirculation, the ability of hypoxia, and respiratory function, resist inflammation and stabilize blood pressure, by elevating levels of malondialdehyde, reducing tumor necrosis factor-α, interleukine-8, and malondialdehyde level to effectively prevent lower limb skeletal muscle ischemia-reperfusion injury on knee arthroplasty.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Reperfusion Injury, Tissue Engineering

CLC Number:

R318

Mei Gao-chang, Li Yuan-hai. Protection of pre-administration of Shengmai injection on ischemia-reperfusion injury of skeletal muscle in lower limb after knee joint replacement[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(53): 7917-7924.

Figures/Tables 3

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