Beneficial postoperative micro-rheological effects of intraoperative administration of diclophenac or ischemic preconditioning in patients with lower extremity operations - Preliminary data

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 knee operations 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 (3x15 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.