Effects of pretreatment with extract of Ginkgo Biloba on tourniquet-induced ischemia-reperfusion injury to the limb

Abstract

Objective To investigate the effects of preconditioning with extract of Ginkgo Biloba (EGB) on the tourniquet-induced ischemia-reperfusion (I/R) injury to the limb. Methods Forty ASA Ⅰ or Ⅱ patients aged 17-64 yr weighing 46-72 kg undergoing lower limb operation under combined spinal-epidural anesthesia (CSEA) were randomly divided into 2 groups (n = 20 each) : group A control and group B EGB. CSEA was performed at L2,3 or L3,4 interspace. The height of sensory block was kept below T10. Group B received EGB 0.3 mg/kg in 100 ml normal saline (NS) injected over 20 min via an intravenous line in the forearm as soon as the tourniquet was inflated while control group received plain NS 100 ml without EGB. Venous blood samples were obtained before tourniquet was inflated (To baseline) and at 5, 10, 20 min after tourniquet was released (T1 , T2, T3) for measurement of blood lactate and MDA concentrations and SOD activity. BP (SP, DP) and HR were continuously monitored and recorded at the above time points. Results In control group DP and SOD activity were significantly decreased while blood lactate and MDA concentrations were significantly increased after tourniquet release as compared with the baseline values before tourniquet was inflated. In EGB group there was no significant change in DP, blood lactate and MDA concentrations and SOD activity after tourniquet was released as compared with the baseline. Conclusion Pretreatment with EGB can protect against tourniquet-induced I/R injury to the limb. Key words: Ginkgo biloba; Plant extracts; Tourniquets; Extremities; Reperfusion injury