Author(s)

J. F. Nnang Essone^1,2, F. Ovono Abessolo³, A. Tsagoulela³, G. Edjo Nkhilli⁴, P. Assoumou⁵, J. A. Bang Ntamack⁵, E. Anyunzok⁶, U. Minkobame⁵, J. F. Meye⁵, E. Ngou Milama³

¹Department of Physiology, Faculty of Medicine and Health Sciences, Libreville, Gabon.
²Department of Anesthesia Resuscitation Emergencies, University Hospital Center of Owendo, Owendo, Gabon.
³Department of Chemistry-Biochemistry, Faculty of Medicine and Health Sciences, Libreville, Gabon.
⁴Anesthesia Resuscitation Service Army Training Hospital, Libreville, Gabon.
⁵Department of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, Libreville, Gabon.
⁶Department of Mathematic and Biostatistic, Faculty of Medicine and Health Sciences, Libreville Gabon.

Introduction: In humans, it has not been established that the use of elastic tourniquet (ET) during myomectomies, whose delivery times do not exceed 90 minutes, which is responsible for ischemia reperfusion (I/R) systemic. Objectives: To study the plasma variations of markers of I/R during myomectomies performed with ET, whose exposure time does not exceed 90 minutes. Population and methods: Plasma créatinin phosphokinase kinase (CPK) and gluthatione peroxydase (GPX) levels of patients with ET myoma (M + G +, n = 19), taken before, during and after exposure, were compared to those of women operated on myoma without tourniquet (M + G -, n = 15), carriers of unoperated myomas (M + G0, n = 20) and controls (M0G0, n = 18). The duration of exposure of the ET was determined, and perioperative variations of GPX, Ca²⁺, K⁺ and CPK between M + G + and others groups were analyzed (p < 0.005). Results: The average duration of exposure of the ET was 51.56 ± 14.12 [30 - 88] min. In M + G +, prior to insertion, CPK was 71.64, GPX 3.537, Ca²⁺ 3.000, K⁺ 3.934, and did not vary from those of M + G - (CPK = 59.354, GPX = 3.205, Ca²⁺ = 2.525, K⁺ = 3.788), M + G0 (CPK = 71.640, GPX = 2.759, Ca²⁺ = 3.004, K⁺ = 3.934) and M0G0 (CPK = 57.2, GPX = 2.306, Ca²⁺ = 2.879, K⁺ = 3.705). Conversely, during the posture (CPK = 95.665, GPX = 3.645, Ca²⁺ = 3.642, K⁺ = 4.757) and after the release of the ET (CPK = 135.443, GPX = 3.694, Ca²⁺ = 3.892, K⁺ = 5.322), these rates were higher among the M + G + compared to the M + G0 and M0G0, but did not differ from those of the M + G - during (CPK = 91.270, GPX = 3.413, Ca²⁺ = 3.068, K⁺ = 4.257) and after release (CPK = 137.776, GPX = 3.632, Ca²⁺ = 3.148, K⁺ = 5.075). Conclusion: The plasmatic concentration of ischemia (CPK, K⁺) and reperfusion (GPX, Ca²⁺) biomarkers does not differ between M + G + and M + G -, but is elevated relatively to controls (M0G0), but also to M + G0’s group. These results show that, for exposure times not exceeding 90 minutes, the elastic tourniquet is probably not the cause of the increase in plasma I/R markers observed in M + G + women. Moreover, these data suggest that the variations of the markers observed during the different surgical stages within each of the two groups of women M + G + and M + G - compared to those of the controls (M0G0) and unoperated myomas (M + G0) are due essentially to the surgical act.

Ischemia, Reperfusion, Uterus, Elastic, Tourniquet

Nnang Essone, J. , Ovono Abessolo, F. , Tsagoulela, A. , Edjo Nkhilli, G. , Assoumou, P. , Bang Ntamack, J. , Anyunzok, E. , Minkobame, U. , Meye, J. and Ngou Milama, E. (2019) Uterine Reperfusion Ischemia and Use of Elastic Tourniquet. Journal of Biosciences and Medicines, 7, 98-119. doi: 10.4236/jbm.2019.72009.