The Role of SCUBE-1 in Ischemia-reperfusion Injury

Study Overview
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Brief Summary
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One consequence of tissue damage caused by tourniquet is ischemia-reperfusion injury. Short-term ischemia leads to vasodilatation and reactive hyperemia resulting in post-ischemic reperfusion microcirculation failure and tissue edema that extends from 30 minutes to 4 hours. SCUBE-1 is a newly defined cell surface molecule. It emerges from many developing cells, including endothelium and platelets. Immunohistochemical demonstration of subendothelial matrix deposition in atherosclerosis in humans. We did not find any study that showed the post-ischemic regression of scube 1, which was shown to be significantly higher in ischemic events in the literature. in this study is aimed to investigate the location / sensitivity of SCUBE-1 in diabetics and nondiabetics after application of regional anesthesia for ischemia-reperfusion injury induced by tourniquet application in knee prosthesis attempts in our aimed patients and compare this with other total antioxidant status (TAS) and MDA of ischemia-reperfusion parameters

Detailed Description
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After being taken to the operation room, the patient will be divided into two groups as group D (diabetic) and group K (control) by standardized anesthesia monitoring with 5-lead electrocardiogram (ECG), peripheral oxygen saturation (SpO2) and noninvasive blood pressure measurements. In both groups, spinal anesthesia will be applied in a lateral decubitus position using a 22 gauge Quincke spinal needle from the interspinal space as 0.5% heavy marcaine 10-12.5 mg 1 min. Atropine 0.5 mg and ephedrine 5 mg should be administered if bradycardia develops in both groups. The disease tourniquet will be applied after induction, in accordance with the literature, to be above 150 mmHg of the systolic blood pressure.

Official Title
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The Role of SCUBE-1 in Ischemia-reperfusion Injury in Patients With Knee Prosthesis

Conditions
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Gonarthrosis, Diabetes

Intervention / Treatment
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* Diagnostic Test: spinal anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diabetes mellitus knee replacement surgery using a pneumatic tourniquet Exclusion Criteria: coronary artery disease renal disorders cognitive disorders bleeding diathesis who have passed general anesthesia anti-inflammatory drugs treatment abnormal HbA1c values

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| diabetic<br>the patients must have diabetic disease | Diagnostic Test: spinal anesthesia<br>* before spinal anesthesia, before 5 min opening of tourniquet and 2 hr after operation SCUBE-1, MDA and TAC will measured from plasma<br>|
| control<br>the patients must not have diabetic | Diagnostic Test: spinal anesthesia<br>* before spinal anesthesia, before 5 min opening of tourniquet and 2 hr after operation SCUBE-1, MDA and TAC will measured from plasma<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SCUBE-1 | mean level of SCUBE-1 | before spinal anesthesia, before 5 min opening of tourniquet and 2 hr after operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| malondialdehyde (MDA) | mean level of MDA | before spinal anesthesia, before 5 min opening of tourniquet and 2 hr after operation | 
| total antioxidant capacity | mean level of total antioxidant capacity (TAC) | before spinal anesthesia, before 5 min opening of tourniquet and 2 hr after operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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SCUBE-1