CoenzymeQ10 and Ischemic Preconditioning Potentially Prevent Tourniquet-Induced Ischemia/Reperfusion in Knee Arthroplasty, but Combined Pretreatment Possibly Neutralizes Their Beneficial Effects

Antioxidants

Yodying Punjasawadwong¹  Kasisin Klunklin²  Nantawit Sugundhavesa²  Siam Tongprasert³  Patraporn Sitilertpisan⁴  Nattayaporn Apaijai⁵  Nipon Chattipakorn⁵  Thidarat Jaiwongkam⁵  Prangmalee Leurcharusmee⁵  Passakorn Sawaddiruk⁵  Siriporn C. Chattipakorn⁵ 

[1] Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;Department of Rehabilitation, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;Faculty of Associated Medical Science, Chiang Mai University, Chiang Mai 50200, Thailand;Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;

关键词: antioxidants;    arthroplasty;    ischemic preconditioning;    mitochondria;    pain;    tourniquet;   

DOI  :  10.3390/antiox11020419

来源: DOAJ

【 摘 要 】

Tourniquet (TQ) use during total knee arthroplasty (TKA) induces ischemia/reperfusion (I/R) injury, resulting in mitochondrial dysfunction. This study aims to determine the effects of coenzyme Q10 (CoQ10) and ischemic preconditioning (IPC), either alone or in combination, on I/R-induced mitochondrial respiration alteration in peripheral blood mononuclear cells (PBMCs) and pain following TKA. Forty-four patients were allocated into four groups: control, CoQ10, IPC, and CoQ10 + IPC. CoQ10 dose was 300 mg/day for 28 days. IPC protocol was three cycles of 5/5-min I/R time. Mitochondrial oxygen consumption rates (OCRs) of PBMCs were measured seven times, at baseline and during ischemic/reperfusion phases, with XFe 96 extracellular flux analyzer. Postoperative pain was assessed for 48 h. CoQ10 improved baseline mitochondrial uncoupling state; however, changes in OCRs during the early phase of I/R were not significantly different from the placebo. Compared to ischemic data, IPC transiently increased basal OCR and ATP production at 2 h after reperfusion. Clinically, CoQ10 significantly decreased pain scores and morphine requirements at 24 h. CoQ10 + IPC abolished analgesic effect of CoQ10 and mitochondrial protection of IPC. In TKA with TQ, IPC enhanced mitochondrial function by a transient increase in basal and ATP-linked respiration, and CoQ10 provides postoperative analgesic effect. Surprisingly, CoQ10 + IPC interferes with beneficial effects of each intervention.

【 授权许可】

Unknown