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Similar long-term cardiovascular effects of propofol or isoflurane anesthesia during ischemia/ reperfusion in dogs

[Effets cardiovasculaires prolongés similaires de l’anesthésie au propofol ou à l’isoflurane pendant l’ischémie/reperfusion chez les chiens]

Kerry Thompson, BSc^*,, Gerald Wisenberg, MD^*,,,, Jane Sykes, RVT^* and R. Terry Thompson, PhD^*,,

^* From the Imaging Division, Lawson Health Research Institute; the Department of Medical Biophysics, and
the Division of Cardiology,
Faculty of Medicine and Dentistry, University of Western Ontario; and the Department of Nuclear Medicine and Magnetic Resonance,
St. Joseph’s Health Care, London, Canada.

Address correspondence to: Kerry Thompson, Imaging Division, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada. Phone: 519-646-6000 ext. 64787; Fax: 519-646-6135; E-mail: kthompso{at}lri.sjhc.london.on.ca

Purpose: To compare the long-term functional and metabolic effects of propofol or isoflurane general anesthesia in a canine model of ischemia/reperfusion.

Methods: Using magnetic resonance (MR) techniques, we monitored both regional metabolism (³¹P MR spectroscopy) and systolic function of the heart (¹H MR imaging) throughout a two-hour occlusion of the left anterior descending coronary artery and ten days of reperfusion. Twenty-two beagles were randomized into isoflurane and propofol general anesthesia groups (n = 10, n = 12 respectively). Contrast-enhanced MR imaging was used to measure infarct size (% of left ventricle that was necrotic) and coronary blood flow was determined using radioactively labelled microspheres.

Results: Cardiac metabolism, as monitored by intracellular pH and high-energy phosphate ratios, was not significantly different between the two groups throughout the protocol. Relative to propofol, isoflurane reduced the depression of left ventricular ejection fraction (EF) during the ischemic period [isoflurane 68.5% ± 4.2%, propofol 58.3% ± 2.0% of baseline (B); P = 0.04], propofol increased the recovery of EF at day three (isoflurane 63.9% ± 4.3%, propofol 74.0% ± 2.5% of B; P = 0.05). By day ten, EF in both groups was similar. Infarct sizes were also similar at day ten (isoflurane 15.7% ± 3.0%, propofol 13.2% ± 2.2%). Normalizing these by the region at risk (volume of tissue with low blood flow during the occlusion) to assess infarct ratios was also not significant (isoflurane 0.58% ± 0.08%, propofol 0.54% ± 0.07%).

Conclusions: There were no significant differences between the two anesthetic groups at day ten, suggesting that any apparent dissimilarities in early cardiovascular effects were short-term only. These results indicate that isoflurane and propofol produce equivalent long-term cardiovascular effects following ischemia/reperfusion.

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