Document Detail

Functional comparison of anaesthetic agents during myocardial ischaemia-reperfusion using pressure-volume loops.
MedLine Citation:
PMID:  19713280     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular (LV) pressure-volume (PV) loops were used to compare the functional effects that accompany the cardioprotection seen with desflurane, sevoflurane, and propofol in a rabbit preparation of coronary ischaemia-reperfusion (IR). METHODS: Male New Zealand White rabbits (n=48) were anaesthetized with propofol (70 mg kg(-1) h(-1)), desflurane (8.9%), or sevoflurane (3.8%) and randomized to receive IR or non-ischaemic time-matched (TC) perfusion protocol. IR groups (desIR, propIR, and sevIR) underwent 30 min of left anterior descending coronary artery occlusion and then 120 min of reperfusion. TC groups (desTC, propTC, and sevTC) were anaesthetized for 150 min without ischaemia. Haemodynamic endpoints included mean arterial pressure, heart rate, cardiac index, systemic vascular resistance index, preload-recruitable stroke-work, time constant of relaxation (tau), and end-diastolic PV relationship (EDPVR). Ventricles in the IR groups were excised and stained with 2,3,5-triphenyl-tetrazolium chloride in order to measure infarct size. RESULTS: Myocardial infarction size was greater in the propIR group [35.74 (sd 11.32)%] compared with the desIR [13.44 (3.09)%] and sevIR [17.96 (6.63)%] groups (P<0.001). EDPVR deteriorated in the sevIR and propIR groups compared with their TC groups, sevTC (P=0.03) and propTC (P=0.044), respectively. There was no difference in any haemodynamic endpoints for the desIR group compared with its TC control (desTC). CONCLUSIONS: During ischaemia, all anaesthetics provide haemodynamic stability and preservation of LV contractility, whereas propofol and sevoflurane, but not desflurane, caused increased LV diastolic stiffness. Desflurane and sevoflurane provide superior cardioprotection compared with propofol.
D T Andrews; A G Royse; C F Royse
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-27
Journal Detail:
Title:  British journal of anaesthesia     Volume:  103     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2009-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  654-64     Citation Subset:  IM    
Cardiovascular and Therapeutics Unit, Department of Pharmacology, University of Melbourne, Melbourne, Australia.
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MeSH Terms
Anesthetics / therapeutic use*
Anesthetics, Inhalation / therapeutic use
Anesthetics, Intravenous / blood,  therapeutic use
Drug Evaluation, Preclinical / methods
Hemodynamics / drug effects
Isoflurane / analogs & derivatives,  therapeutic use
Methyl Ethers / therapeutic use
Myocardial Infarction / pathology,  prevention & control
Myocardial Reperfusion / methods
Myocardial Reperfusion Injury / prevention & control*
Propofol / blood,  therapeutic use
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Anesthetics; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 57041-67-5/desflurane

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