Document Detail

Anesthetic preconditioning combined with postconditioning offers no additional benefit over preconditioning or postconditioning alone.
MedLine Citation:
PMID:  17646483     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent investigations demonstrate that anesthetic preconditioning and postconditioning reduce myocardial infarct size to a degree comparable to that achieved with ischemic preconditioning. We hypothesized that the combination of sevoflurane preconditioning and postconditioning would result in greater preservation of myocardium. METHODS: Langendorff perfused rat hearts were divided into four groups: control, preconditioning, postconditioning, and preconditioning plus postconditioning. During reperfusion, left ventricular function (left ventricular developed pressure, left ventricular end diastolic pressure, and dp/dt) were measured. At the end of reperfusion, the infarct sizes were measured with 2,3,5 triphenyltetrazolium chloride staining. Nuclear magnetic resonance was used to measure intracellular pH, Na(+), and Ca(2+). RESULTS: Left ventricular developed pressure, left ventricular end diastolic pressure, left ventricular dp/dt(max) and dp/dt(min) were significantly improved in the treatment groups when compared with those in the controls. Myocardial infarct size (24% +/- 7%, 16% +/- 8%, and 22% +/- 7% in preconditioning, postconditioning, and pre-plus postconditioning groups versus 44% +/- 8% in the control group, P < 0.05) and intracellular Na(+) and Ca(2+) were significantly decreased in all experimental groups at the end of reperfusion when compared with those in control. However, there were no differences between these variables in each treatment group. CONCLUSION: Sevoflurane postconditioning is as effective as preconditioning in protecting myocardial function after global ischemia. The combination of sevoflurane preconditioning and postconditioning offered no additional benefit over either intervention alone.
David I Deyhimy; Neal W Fleming; Ian G Brodkin; Hong Liu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-24     Completed Date:  2007-08-20     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  316-24     Citation Subset:  AIM; IM    
Department of Anesthesiology and Pain Medicine, University of California, Davis, CA, USA.
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MeSH Terms
Anesthetics, Inhalation / pharmacology,  therapeutic use*
Heart Rate / drug effects,  physiology
Ischemic Preconditioning, Myocardial / methods*
Methyl Ethers / pharmacology,  therapeutic use
Myocardial Ischemia / metabolism,  prevention & control
Myocardial Reperfusion Injury / metabolism,  prevention & control
Postoperative Care / methods*
Rats, Inbred F344
Time Factors
Ventricular Function, Left / drug effects,  physiology
Grant Support
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane
Comment In:
Anesth Analg. 2007 Dec;105(6):1863; author reply 1863-4   [PMID:  18042898 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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