This Article Résumé de cet Article Full Text Full Text (PDF) Additional material Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Obal, D. Articles by Schlack, W. Search for Related Content PubMed PubMed Citation Articles by Obal, D. Articles by Schlack, W.

Cardioprotection against reperfusion injury is maximal with only two minutes of sevoflurane administration in rats

[La cardioprotection contre les lésions de reperfusion est maximale après deux minutes seulement d’administration de sévoflurane chez des rats]

From the Klinik für Anaesthesiologie, Universitätsklinikum Düsseldorf, Germany.

Address correspondence to: Professor Dr. Wolfgang Schlack, Klinik für Anaesthesiologie, Universitätsklinikum Düsseldorf, Postfach 10 10 07, D-40001 Düsseldorf, Germany. Phone: 49-211-811-8669; Fax: 49-211-811-6253; E-mail: schlack{at}uni-duesseldorf.de

Purpose: Volatile anesthetics can protect the heart against reperfusion injury. When sevoflurane is given for the first 15 min of reperfusion, a concentration corresponding to one minimum alveolar concentration (MAC) provides a maximum protective effect. The present study addresses the question of how long sevoflurane has to be administered to achieve the best cardioprotection.

Methods: Chloralose anesthetized rats were subjected to a 25-min occlusion of a major coronary artery, followed by 90 min of reperfusion. During the initial phase of reperfusion, an end-tidal concentration of 2.4 vol.% of sevoflurane (1 MAC) was given for two (n = 8), five (n = 8) or ten minutes (n = 7). Seven rats served as untreated controls. We measured left ventricular (LV) pressure, mean aortic pressure and infarct size (triphenyltetrazolium staining).

Results: Administration of sevoflurane for two minutes resulted in the greatest reduction of infarct size to 15% (8–22 [mean (95% confidence interval)] of the area at risk compared with controls [51 (47–55) %, P < 0.001]. Five or ten minutes of sevoflurane administration reduced infarct size to 26 (18–34) and 26 (18–35) % [P < 0.05], respectively. The cardiodepressant effect of sevoflurane varied with the duration of its administration: LV dP/dt was reduced from 6332 mmHg•sec^-1 (5771–6894) during baseline to 4211 mmHg•sec^-1 (3031–5391), 3811 mmHg•sec^-1 (2081–5540) and 3612 mmHg•sec^-1 (2864–4359) after two, five and ten minutes of reperfusion, respectively.

Conclusion: Administration of 1 MAC sevoflurane for the first two minutes of reperfusion effectively protects the heart against reperfusion injury in rats in vivo. A longer administration time had lesser cardioprotective effects in this experimental model.

This article has been cited by other articles:

				D. Obal, S. Dettwiler, C. Favoccia, H. Scharbatke, B. Preckel, and W. Schlack The Influence of Mitochondrial KATP-Channels in the Cardioprotection of Preconditioning and Postconditioning by Sevoflurane in the Rat In Vivo Anesth. Analg., November 1, 2005; 101(5): 1252 - 1260. [Abstract] [Full Text] [PDF]

				E. Lucchinetti, R. da Silva, T. Pasch, M. C. Schaub, and M. Zaugg Anaesthetic preconditioning but not postconditioning prevents early activation of the deleterious cardiac remodelling programme: evidence of opposing genomic responses in cardioprotection by pre- and postconditioning Br. J. Anaesth., August 1, 2005; 95(2): 140 - 152. [Abstract] [Full Text] [PDF]