Background and objective: Tourniquet use is a common tool in surgical procedures of the limbs. Hydroxyethyl starch (HES) 130/0.4 not only has a role in replacement of the liquid deficits due to trauma, bleeding or shock, but it is also effective in enhancing tissue oxygen tension and regulation of microcirculation. The aim of this study was to investigate how 6% HES 130/0.4 affects ischaemia and reperfusion in skeletal muscle. Methods: An ischaemia/reperfusion model (3 and 2h, respectively) was applied in 14 rabbits. Group S (n=7) was infused with 0.9% NaCl (0.2 ml kg-1min -1) and group HES was infused with 6% HES 130/0.4 (0.2 ml kg -1min-1). The total liquid was divided into equal one-thirds and given in the preischaemia, ischaemia and reperfusion phases. Ketamine HCl (30 mg kg-1) was used for anaesthesia, and blood pressure, pulse and blood gases were monitored. Muscle biopsies were taken in the preischaemic (A), ischaemic (B) and reperfusion (C) phases. In these samples, nitrite, nitrate, reduced glutathione (GSH) and myeloperoxidase (MPO) were measured to assess oxidative stress elements, and malondialdehyde (MDA) was measured to assess lipid peroxidation. Repeated variance analysis, Mann-Whitney U test and Student's t test were used for statistical analysis of these parameters. Results: In group S, the MPO levels were significantly increased in the reperfusion phase compared with baseline, whereas there was a decrease in MPO levels in the reperfusion period in the HES group. This difference between groups was statistically significant (P=0.011). Conclusion: The results of this study showed that 6% HES 130/0.4 solution is more effective in the prevention of ischaemia/reperfusion injury than saline when given in the same volume. © 2009 European Society of Anaesthesiology.