Sevoflurane and desflurane protect cholinergic-induced bronchoconstriction of hyperreactive airways in rabbits

Abstract

Purpose The potential of desflurane to alter respiratory mechanics in the presence of bronchial hyperresponsiveness (BHR) is still a subject of debate. Accordingly, we evaluated the bronchoprotective potential of desflurane compared with sevoflurane following cholinergic lung constriction in rabbits with normal and hyperreactive airways. Methods The input impedance of the respiratory system (Zrs) was measured during midazolam-based anesthesia before and during intravenous infusions of increasing doses of methacholine (MCh). The rabbits in the control group (Group C) were then randomized to receive either sevoflurane 1 MAC followed by desflurane 1 MAC or vice versa, whereas ovalbumin-sensitized rabbits received sevoflurane followed by desflurane (Group S-SD) or vice versa (Group S-DS). Baseline Zrs measurements and the MCh provocations were repeated under the maintenance of each volatile agent. Airway resistance (Raw), tissue damping (G), and elastance data were obtained from Zrs by model fitting.Results Similar bronchoprotective effects of sevoflurane and desflurane against MCh-induced bronchoconstriction were observed independently of the severity of the bronchospasm and the presence of BHR. With sevoflurane, the decreases in Raw ranged from 22 (8.8)% to 44 (12)%, and with desflurane, they ranged from 22 (8.7)% to 50 (12)%. The increases in G reflecting the enhanced ventilation heterogeneities in the lung periphery were not affected by the volatile agents. Conclusions If the contractile stimulus is cholinergic in origin, sevoflurane and desflurane exert similar bronchoprotective potentials to act against lung constriction independent of the presence of BHR. These volatile anesthetics otherwise lack a potential to improve the enhanced ventilation heterogeneities that develop particularly in the presence of BHR. RésuméObjectif Le potentiel de desflurane a`alte´rer r la me´canique respiratoire en pre´sence d'hyperre´activiteb ronchique (HRB) est encore sujet a`controverse. C'est pourquoi nous avons e´value´le potentiel de protection bronchique du desflurane par rapport au se´voflurane a`la suite d'une constriction pulmonaire cholinergique chez des lapins pre´sentant des voies ae´riennes normales et hyperre´actives. Méthode L'impe´dance dusyste`me respiratoire (Zrs) a e´teḿ esure´e pendant une anesthe´sie re´alise´e à l'aide de

Sevoflurane Inhibits Nuclear Factor-κB Activation in Lipopolysaccharide-Induced Acute Inflammatory Lung Injury via Toll-Like Receptor 4 Signaling

“…Sevoflurane is one of the most commonly used volatile anesthetics. Additionally, sevoflurane produces anti-inflammatory and bronchiodilatory effects by unknown mechanisms [ 21 – 23 ]. Some studies showed that sevoflurane inhibited neutrophil function and the production of reactive oxygen species (ROS) in ischemic reperfusion injuries [ 25 , 35 ].…”

“…Some studies reported that volatile anesthetics delivered by mechanical ventilation alleviated lung inflammation by reducing TNF-α and nitric oxide release in rats that had received intratracheal LPS [ 16 – 20 ]. Sevoflurane is commonly used to sedate patients prior to intubation for mechanical ventilation because of its good controllability [ 21 ]. Recently, additional advantages of sevoflurane have been reported, including dilation of bronchioles and reduction of bronchial hyperresponsiveness in patients with asthma, indicating that it has lung protective effects [ 21 – 23 ].…”

“…Sevoflurane is commonly used to sedate patients prior to intubation for mechanical ventilation because of its good controllability [ 21 ]. Recently, additional advantages of sevoflurane have been reported, including dilation of bronchioles and reduction of bronchial hyperresponsiveness in patients with asthma, indicating that it has lung protective effects [ 21 – 23 ]. However, the mechanism of these effects remains unclear.…”

“…However, the mechanism of these effects remains unclear. Reversible inhibition of voltage-dependent calcium channels and decreased intracellular calcium mobilization may result in a decreased concentration of intracellular calcium in response to volatile anesthetics [ 21 , 24 ].…”

Levosimendan prevents bronchoconstriction and adverse respiratory tissue mechanical changes in rabbits

“…Moreover, indirect mechanisms associated with prevention of lung volume loss by inhibiting peripheral airway closures might have also contributed to the observed effects of levosimendan on the G and H responses. Interestingly, the ability of levosimendan to prevent MCh-induced elevations in respiratory tissue damping and stiffness is more pronounced than that of the volatile anesthetic agents, where opening the K ATP channels has little (24) or no effect on this lung compartment (17,28). This feature of levosimendan confirms its potent beneficial action on the lung periphery, as outlined above.…”