Document Detail


Effects of sevoflurane and propofol on ischaemia-reperfusion injury after thoracic-aortic occlusion in pigs.
MedLine Citation:
PMID:  17371775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thoraco-abdominal-aneurysm surgery predicts high mortality. Propofol and sevoflurane are commonly used anaesthetics for this procedure. Halogenated anaesthetics induce organ protection similar to ischaemic preconditioning. We investigated which anaesthetic regimen would lead to a better protection against ischaemia-reperfusion injury induced by temporary thoracic-aortic occlusion. METHODS: Following initial fentanyl-midazolam anaesthesia for surgical preparation, 18 pigs were randomly assigned to two groups: group one received propofol (n=9) and group two sevoflurane (n=9) before, during, and after lower body ischaemia in an investigator blinded fashion. Ten animals without aortic occlusion served as time controls (propofol, n=5; sevoflurane, n=5). For induction of ischaemia, the thoracic aorta was occluded by a balloon-catheter for 90 min. After 120 min of reperfusion, the study anaesthetics were discontinued and fentanyl-midazolam re-established for an additional 180 min. Goal-directed therapy was performed during reperfusion. Fluid and catecholamine requirements were assessed. Serum samples and intestinal tissue specimens were obtained. RESULTS: Severe declamping shock occurred in both study groups. While norepinephrine requirements in the sevoflurane group were significantly reduced during reperfusion (P<0.05), allowing cessation of catecholamine support in 4/9 animals, all 9/9 animals were still catecholamine dependent at the end of the experiment in the propofol group. Serum activities of lactate dehydrogenase, aspartate transaminase, and alanine aminotransferase were lower with sevoflurane (P<0.05). Small intestine tissue specimens did not differ histologically. CONCLUSIONS: Use of sevoflurane compared with propofol attenuated the haemodynamic sequelae of reperfusion injury in our model. Release of serum markers of cellular injury was also attenuated.
Authors:
T Annecke; J C Kubitz; S Kahr; J M Hilberath; K Langer; G I Kemming; M Rehm; I Bittmann; P F Conzen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-19
Journal Detail:
Title:  British journal of anaesthesia     Volume:  98     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-25     Completed Date:  2007-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  581-90     Citation Subset:  IM    
Affiliation:
Clinic of Anaesthesiology, Institute for Surgical Research, Ludwig-Maximilians-University, University Hospital, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation / therapeutic use
Anesthetics, Intravenous / therapeutic use
Animals
Aortic Aneurysm, Thoracic / surgery*
Blood Pressure / drug effects
Constriction
Drug Administration Schedule
Enzymes / blood
Epinephrine / administration & dosage
Female
Jejunum / pathology
Lactates / blood
Male
Methyl Ethers / therapeutic use*
Norepinephrine / administration & dosage
Oxygen Consumption / drug effects
Propofol / therapeutic use*
Pulmonary Wedge Pressure / drug effects
Random Allocation
Reperfusion Injury / etiology,  pathology,  physiopathology,  prevention & control*
Swine
Vasoconstrictor Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Enzymes; 0/Lactates; 0/Methyl Ethers; 0/Vasoconstrictor Agents; 2078-54-8/Propofol; 28523-86-6/sevoflurane; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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


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