Effects of spinal or general anesthesia on F 2 -isoprostanes and isofurans during ischemia/reperfusion of the leg in patients undergoing knee replacement surgery

Emilie Mas, Anne E. Barden, Tomas B. Corcoran, Michael Phillips, L. Jackson Roberts, Trevor A. Mori

Research output: Contribution to journalArticleResearchpeer-review

25 Citations (Scopus)


General and spinal anesthesia are used extensively in orthopedic surgery. However, these methods of anesthesia may result in different amounts of oxygen being delivered to the patient. Ischemia/reperfusion injury after release of the tourniquet initiates free radical-mediated oxidative stress. F 2 -isoprostanes are reliable markers of in vivo lipid peroxidation. However, under conditions of high oxygen tension, isofurans are formed. We aimed to compare plasma isofurans and F 2 -isoprostanes in spinal versus general anesthesia in patients undergoing knee-replacement surgery in a randomized, blinded study. Thirty-nine patients were randomized to spinal (SA; n = 19) or general anesthesia (GA; n = 20). Blood was collected before anesthesia, and a tourniquet was then applied to the limb during surgery. After release of the tourniquet, blood samples were collected at 30 min, 2 h, and 24 h for measurement of plasma F 2 -isoprostanes and isofurans by gas chromatography-mass spectrometry. The two groups were comparable in age and body mass index. Plasma F 2 -isoprostanes were significantly lower in the GA patients compared with the SA patients (p = 0.045). In contrast, the GA patients had significantly elevated plasma isofurans (p = 0.032). Increased isofurans during GA compared with SA are likely to reflect increased oxidative stress due to elevated oxygen concentrations during GA. Further studies are required to assess the implications of these findings on perioperative outcomes.

Original languageEnglish
Pages (from-to)1171-1176
Number of pages6
JournalFree Radical Biology and Medicine
Issue number9
Publication statusPublished - May 2011
Externally publishedYes


  • Anesthesia
  • Free radicals
  • Ischemia/reperfusion
  • Isofurans
  • Isoprostanes

Cite this