Isoflurane Improves the Tolerance to Pacing-induced Myocardial Ischemia

Tarnow, J.; Markschies-Hornung, Alexandra; Schulte-Sasse, U.

doi:10.1097/00000542-198602000-00004

Cited by 69 publications

(7 citation statements)

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“…It has long been recognized that volatile anaesthetic agents have negative inotropic and chronotropic properties, and thus decrease the oxygen consumption -supply ratio and improve the capability to maintain myocardial energy stores. 84 Tarnow and colleagues 94 demonstrated in 1986 that patients receiving isoflurane during coronary artery bypass procedures were less susceptible to pacing-induced myocardial ischaemia. Compared with other strategies known to protect against ischaemia -reperfusion injury, the contribution of this direct anti-ischaemic effect is small.…”

Section: Interventions During Ischaemiamentioning

confidence: 99%

Anaesthesia and myocardial ischaemia/reperfusion injury

Frässdorf

Hert

Schlack

2009

British Journal of Anaesthesia

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Anaesthetists are confronted on a daily basis with patients with coronary artery disease, myocardial ischaemia, or both during the perioperative period. Therefore, prevention and ultimately adequate therapy of perioperative myocardial ischaemia and its consequences are the major challenges in current anaesthetic practice. This review will focus on the translation of the laboratory evidence of anaesthetic-induced cardioprotection into daily clinical practice.

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Section: Interventions During Ischaemiamentioning

confidence: 99%

Anaesthesia and myocardial ischaemia/reperfusion injury

Frässdorf

Hert

Schlack

2009

British Journal of Anaesthesia

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“…This is in line with the ECG findings in one of our patients. In contrast, in another study (14), isoflurane was shown to improve the tolerance to increases in heart rate, induced by pacing, evaluated from ECG, pulmonary capillary wedge pressure and central venous pressure. In a recent study where isoflurane was given as an adjunct to highdose sufentanil anesthesia, for control of intraoperative hypertension, no change in lactate metabolism was detected (1 5).…”

Section: Discussionmentioning

confidence: 82%

Isoflurane and intravenous anesthesia used for induction before coronary artery bypass grafting

Dahlgren

Öhqvist

et al. 1989

Acta Anaesthesiol Scand

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Induction of anesthesia with isoflurane in combination with fentanyl, thiopentone, nitrous oxide and pancuronium was studied in nine patients scheduled for coronary artery bypass grafting. Ejection fraction (EF) of the left ventricle was monitored with a single crystal probe linked to a microcomputer, after injection of 200 MBq Tc 99m-HSA. Stroke volume index determined by thermodilution and EF were used to calculate left ventricular end-diastolic volume index (LVEDVI). The degree of ischemia was numerically scored as evaluated from the ECG (modified VS lead). The study protocol covered seven periods from awake before induction to 5 min after intubation. EF decreased moderately during intubation (P< 0.05). Systemic vascular resistance index (SVRI) was decreased (P<0.05) at all times except during intubation when it was unchanged compared to control. LVEDVI decreased during induction ( P < 0.05), while left ventricular filling pressure remained unchanged. Heart rate did not change. Systolic arterial pressure decreased from 147 mrnHg (19.6 kPa) to about 100 mmHg (13.3 kPa) during induction ( P < 0.05). Two patients were given vasoconstrictors because of low arterial pressure. The mean ischemic score did not change. One patient, however, had signs of progressive ischemia. In this patient isoflurane administration was stopped after the last recording and the ECG normalized within 20 min.

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“…Tarnow and associates [68] investigated the effects of atrial pacing on the ECG V5 STsegment before and during isoflurane-nitrous oxide anaesthesia in patients with CAD and normal LV function. When patients were paced during anaesthesia to the same heart rate that produced angina and significant ST-depression while awake, they had significantly less ST- Changes in rate-pressure product v. ST-segments with coronary artery disease awake (O) and anaesthetized with isoflurane-nitrous oxide (•).…”

Section: Fig 3 Schematic Diagram Of the Coronary Circulation Show-mentioning

confidence: 99%

Myocardial Ischaemia Associated With General Anaesthesia

Reiz

1988

British Journal of Anaesthesia

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Isoflurane Improves the Tolerance to Pacing-induced Myocardial Ischemia

Cited by 69 publications

References 0 publications

Anaesthesia and myocardial ischaemia/reperfusion injury

Anaesthesia and myocardial ischaemia/reperfusion injury

Isoflurane and intravenous anesthesia used for induction before coronary artery bypass grafting

Myocardial Ischaemia Associated With General Anaesthesia

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