Functional comparison of anaesthetic agents during myocardial ischaemia-reperfusion using pressure-volume loops.
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.
Andrews
D T
DT
Cardiovascular and Therapeutics Unit, Department of Pharmacology, University of Melbourne, Melbourne, Australia. andrewsdt@me.com
Royse
A G
AG
Royse
C F
CF
D000777:Anesthetics / Q000627:therapeutic use*; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000097:blood / Q000627:therapeutic use; D000818:Animals; D000077335:Desflurane; D004353:Drug Evaluation, Preclinical / Q000379:methods; D006439:Hemodynamics / Q000187:drug effects; D007530:Isoflurane / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000473:pathology / Q000517:prevention & control; D015425:Myocardial Reperfusion / Q000379:methods; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D015742:Propofol / Q000097:blood / Q000627:therapeutic use; D011817:Rabbits; D000077149:Sevoflurane; D016277:Ventricular Function, Left / Q000187:drug effects
D000777:Anesthetics; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol