CoenzymeQ10 and Ischemic Preconditioning Potentially Prevent Tourniquet-Induced Ischemia/Reperfusion in Knee Arthroplasty, but Combined Pretreatment Possibly Neutralizes Their Beneficial Effects.
Prangmalee LeurcharusmeePassakorn SawaddirukYodying PunjasawadwongNantawit SugundhavesaKasisin KlunklinSiam TongprasertPatraporn SitilertpisanThidarat JaiwongkamNattayaporn ApaijaiNipon ChattipakornSiripron C ChattipakornPublished in: Antioxidants (Basel, Switzerland) (2022)
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.
Keyphrases
- cerebral ischemia
- total knee arthroplasty
- ischemia reperfusion injury
- oxidative stress
- postoperative pain
- randomized controlled trial
- subarachnoid hemorrhage
- chronic pain
- blood brain barrier
- total hip
- acute myocardial infarction
- end stage renal disease
- pain management
- diabetic rats
- chronic kidney disease
- high glucose
- clinical trial
- brain injury
- patients undergoing
- newly diagnosed
- drug induced
- machine learning
- acute coronary syndrome
- atrial fibrillation
- nitric oxide
- electronic health record
- left ventricular
- artificial intelligence
- percutaneous coronary intervention
- patient reported