A single blind randomized trial about efficacy of the remote ischemic preconditioning for the development of deep vein thrombosis during total knee arthroplasty using the tourniquet.

Research Project

Project/Area Number	23659737
Research Category	Grant-in-Aid for Challenging Exploratory Research
Allocation Type	Multi-year Fund
Research Field	Anesthesiology/Resuscitation studies
Research Institution	University of Toyama
Principal Investigator	SHAKUNAGA Kiyoshi 富山大学, 大学病院, 准教授 (40187498)
Project Period (FY)	2011-04-28 – 2015-03-31
Project Status	Completed (Fiscal Year 2014)
Budget Amount *help	¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000) Fiscal Year 2013: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2012: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000) Fiscal Year 2011: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords	遠隔虚血プレコンディショニング / 可溶性フィブリンモノマー複合体 / NFκ-B / IL-6 / IL-10 / 虚血再潅流障害 / 全人工膝関節形成術 / 遠隔虚血プレコンディションイング / 虚血再潅流 / 凝固活性動態 / 炎症反応 / NF-κB活性 / 人工膝関節置換術 / 駆血帯 / 虚血再灌流障害 / 深部静脈血栓症 / NF-κB 活性 / サイトカイン / 抗炎症効果 / 深部静脈塞栓症 / 抗炎症性効果
Outline of Final Research Achievements	We have studied effects of remote ischemic preconditioning (RIPC) on the development of deep vein thrombosis and inflammatory reaction during total knee arthroplasty using the tourniquet prospectively. RIPC (four five-minute cycles of occlusion and reperfusion in the upper limb) resulted in significantly decreased the soluble fibrin monomer complex levels　after 20 minutes following tourniquet deflation. Our findings suggest that RIPC have an inhibitory effect for thrombus formation immediately after surgery at least in the short term. Moreover, we observed that the reduction of NFκ-B activity and IL-6 production and that increased production of anti-inflammatory cytokine IL-10 in the RIPC group. Our data suggest that RIPC attenuate activation of NFκ-B and then modulate the inflammatory response.