REMOTE ISCHEMIC PRECONDITIONING AND ITS EFFECTS ON ENDOTHELIAL FUNCTION AND OXIDATIVE STRESS DURING SURGERY

Abstract

Aim of the study: To comprehensively investigate the impact of remote ischemic preconditioning(RIPC)on endothelial function, nitric oxide bioavailability, and oxidative stress within the context of surgical procedures, and to elucidate the underlying mechanisms and potential clinical implications of remote ischemic preconditioning as a protective strategy against ischemia-reperfusion injury in the surgical setting. Research Design: A prospective, randomized controlled study was performed, enrolling patients undergoing elective surgical procedures known to be associated with a risk of ischemia-reperfusion injury. The study involved comprehensive monitoring of endothelial function through flow-mediated dilation, assessment of nitric oxide bioavailability via plasma nitrite and nitrate levels, and quantification of oxidative stress markers, such as malondialdehyde and superoxide dismutase activity. Findings: RIPC improved endothelial function, enhanced nitric oxide bioavailability, and mitigated oxidative stress during and after surgery, potentially reducing perioperative complications and improving patient outcomes. Implications: The findings are expected to inform clinical practice by providing evidence-based support for the use of RIPC as a simple, non-invasive, and cost-effective approach to protect patients undergoing surgery from the detrimental effects of ischemia-reperfusion injury, potentially improving surgical safety and patient recovery. Originality: This study offers new insights into the protective effects of RIPC on the endothelium and its associated pathways in surgical scenarios, thus paving the way for innovative strategies to minimize ischemia-reperfusion injury and enhance surgical outcomes.