title: Comparison of 5 different remifentanil strategies against myocardial ischemia-reperfusion injury.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects of various remifentanil strategies (preconditioning, postconditioning, or continuous infusion) against myocardial ischemia-reperfusion injury.
  
  
  METHODS
  An in vitro experimental study using the Langendorff system.
  
  
  METHODS
  A university research laboratory.
  
  
  METHODS
  Male Sprague-Dawley rats (each n = 9).
  
  
  METHODS
  Five different remifentanil strategies were performed in isolated rat hearts as follows: remifentanil preconditioning (R-Pre), remifentanil postconditioning (R-Post), ischemic targeting remifentanil (R1), reperfusion targeting remifentanil (R2), or both ischemic and reperfusion targeting remifentanil (R3). Infarct size and cardiodynamics were compared.
  
  
  RESULTS
  The infarct-risk volume ratio in groups R-Pre (13.7% ± 9.9%), R-Post (13.7% ± 12.3%), and R3 (12.6% ± 6.1%) were decreased significantly compared with the untreated control hearts (32.9% ± 11.1%, p &lt 0.01). There was no significant difference in the left ventricular-developed pressure (LVDP) recovery after reperfusion between the control (43.6% ± 14.5%) and R-Pre (34.8% ± 12.9%, p > 0.05) groups after reperfusion. However, the LVDP recovery in R-Post (21.6% ± 7.7%, p < 0.05), R1 (16.7% ± 19.8%, p < 0.01), R2 (22.2% ± 13.9%, p < 0.05), and R3 (16.2% ± 7.8%, p < 0.01) was decreased significantly compared with control hearts. There was no significant difference in the recovery of dP/dt(max) after reperfusion between the R-Pre (42.0% ± 16.9%) and control groups (39.0% ± 15.4%, p > 0.05), whereas the dP/dt(max) in R3 group (16.9% ± 9.0%) was decreased significantly compared with R-Pre (p < 0.05).
  
  
  CONCLUSIONS
  Preconditioning or postconditioning by remifentanil and the continuous infusion of remifentanil effectively reduce myocardial infarction, whereas reperfusion targeting ischemic targeting or reperfusion targeting remifentanil does not. Remifentanil preconditioning better preserves myocardial function, especially LVDP, than other remifentanil strategies.
authors.affiliation: Institute of Cardiovascular Research, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Republic of Korea.
authors.forename: Kook Jin
authors.initials: KJ
authors.lastname: Chun
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Youngho
authors.initials: Y
authors.lastname: Jang
authors.forename: June Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Lee
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D000818:Animals; D001835:Body Weight / Q000502:physiology; D002316:Cardiotonic Agents; D004396:Coloring Agents; D003326:Coronary Circulation / Q000502:physiology; D006321:Heart / Q000187:drug effects; D006334:Heart Function Tests; D066298:In Vitro Techniques; D057775:Ischemic Postconditioning / Q000379:methods*; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D009203:Myocardial Infarction / Q000473:pathology / Q000517:prevention & control; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009929:Organ Size / Q000502:physiology; D010880:Piperidines / Q000008:administration & dosage / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000077208:Remifentanil; D015424:Reperfusion; D013778:Tetrazolium Salts; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D018686:Anesthetics, Intravenous; D002316:Cardiotonic Agents; D004396:Coloring Agents; D010880:Piperidines; D013778:Tetrazolium Salts; C009591:triphenyltetrazolium; D000077208:Remifentanil