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

Can J Anaesth. 2003 Nov;50(9):940-5. doi: 10.1007/BF03018744.

Abstract

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 x sec(-1) (5771-6894) during baseline to 4211 mmHg x sec(-1) (3031-5391), 3811 mmHg x sec(-1) (2081-5540) and 3612 mmHg x 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.

MeSH terms

  • Analysis of Variance
  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Inhalation / therapeutic use
  • Animals
  • Blood Pressure / drug effects
  • Cardiotonic Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Heart Rate / drug effects
  • Methyl Ethers / administration & dosage
  • Methyl Ethers / therapeutic use*
  • Myocardial Infarction / prevention & control*
  • Myocardial Reperfusion Injury / prevention & control*
  • Rats
  • Rats, Wistar
  • Sevoflurane
  • Time Factors
  • Vascular Resistance / drug effects

Substances

  • Anesthetics, Inhalation
  • Cardiotonic Agents
  • Methyl Ethers
  • Sevoflurane