الفهرس 
SKELETAL MUSCLE METABOLISM
Creatine metabolismOnly 14 pages are availabe for public view
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Abstract
Ischemia-reperfusion (I/R) is one of the main pathophysiological phenomena seen in the anesthetic practice (organ transplantation, coronary surgery, cardiopulmonary bypass, restoration of hypovolemic shock, etc.) and that causes local and systemic inflammatory response.
Muscle ischemia is accompanied by hypoxic cellular challenge and anaerobic glycolysis, and reperfusion by neutrophil activation, formation of reactive oxygen species, and release of vasoactive factors.
Experimental and clinical data provide evidence for a protective role of volatile anesthetics against myocardium I/R injury. The volatile anesthetics such as sevoflurane seems to have such a role in the skeletal muscle .sevoflurane inhalation provides endothelial protection against ischemia-reperfusion in skeletal muscles.
This study was done to investigate the protective potentials of Sevoflurane, propofol, and spinal anes-thesia against Ischemia-reperfusion injury (I/R) in lower limb surgeries under tourniquet,the study was done in 3 groups (20 patients/each).
1- Spinal group.
2- Sevoflurane group.
3- Propofol group.
Biochemical analysis:
1- Lactate.
2- Pyruvate.
3- Glucose.
4- Creatine kinase.
Hemodynamic data:
1- ECG.
2- Mean arterial blood pressure.
3- Heart rate.
4- Oxygen saturation.
Our results indicated that sevoflurane used as protective drug before skeletal muscle tourniquet induced I/R optimizes interstitial release of energy metabolic substrates (glucose, pyruvate, lactate) and decrease creatine kinase production. In contrast, propofol seems to impair the energy metabolism response of skeletal muscle to tourniquet-induced I/R. These findings may have some importance for the choice of anesthetics in patients undergoing limb surgery with a tourniquet.