Similar long-term cardiovascular effects of propofol or isoflurane anesthesia during ischemia/ reperfusion in dogs

Abstract

P Pu ur rp po os se e: : To compare the long-term functional and metabolic effects of propofol or isoflurane general anesthesia in a canine model of ischemia/reperfusion. M Me et th ho od ds s: :Using magnetic resonance (MR) techniques, we monitored both regional metabolism ( 31 P MR spectroscopy) and systolic function of the heart ( 1 H MR imaging) throughout a two-hour occlusion of the left anterior descending coronary artery and ten days of reperfusion. Twenty-two beagles were randomized into isoflurane and propofol general anesthesia groups (n = 10, n = 12 respectively). Contrast-enhanced MR imaging was used to measure infarct size (% of left ventricle that was necrotic) and coronary blood flow was determined using radioactively labelled microspheres.R Re es su ul lt ts s: : Cardiac metabolism, as monitored by intracellular pH and high-energy phosphate ratios, was not significantly different between the two groups throughout the protocol. Relative to propofol, isoflurane reduced the depression of left ventricular ejection fraction (EF) during the ischemic period [isoflurane 68.5% ± 4.2%, propofol 58.3% ± 2.0% of baseline (B); P = 0.04], propofol increased the recovery of EF at day three (isoflurane 63.9% ± 4.3%, propofol 74.0% ± 2.5% of B; P = 0.05). By day ten, EF in both groups was similar. Infarct sizes were also similar at day ten (isoflurane 15.7% ± 3.0%, propofol 13.2% ± 2.2%). Normalizing these by the region at risk (volume of tissue with low blood flow during the occlusion) to assess infarct ratios was also not significant (isoflurane 0.58% ± 0.08%, propofol 0.54% ± 0.07%).C Co on nc cl lu us si io on ns s: : There were no significant differences between the two anesthetic groups at day ten, suggesting that any apparent dissimilarities in early cardiovascular effects were short-term only. These results indicate that isoflurane and propofol produce equivalent long-term cardiovascular effects following ischemia/reperfusion. [isoflurane : 68,5 %± 4,2 %, propofol : 58,3 % ± 2,0 % des données de base (B) ; P = 0,04], le propofol a accéléré la récupération de la FE au jour trois (isoflurane : 63,9 % ± 4,3 %, propofol : 74,0 % ± 2,5 % de B ; P = 0,05). Au dixième jour, la FE était similaire dans les deux groupes, de même la taille de l'infarctus (isoflurane : 15,7 % ± 3,0 %, propofol : 13,2 % ± 2,2 %). La normalisation de ces données, selon la région à risque (volume de tissu soumis à un faible débit sanguin pendant l'occlusion), réalisée pour évaluer les ratios d'infarctus n'a pas été significative non plus (isoflurane : 0,58 % ± 0,08 %, propofol : 0,54 % ± 0,07 %). Objectif : Comparer les effets fonctionnels et métaboliques prolongés de l'anesthésie générale avec du propofol ou de l'isoflurane chez un modèle canin d'ischémie/reperfusion. Méthode : Nous avons mesuré, grâce aux techniques d'imagerie par résonance magnétique (IRM), le métabolisme régional (spectroscopie IRM 31P) et la fonction systolique cardiaque (IRM 1H) tout au long d'une occlusion de deux heures de l'artère descendante antérieure et...

Inflammatory response and cardioprotection during open‐heart surgery: the importance of anaesthetics

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Propofol has delayed myocardial protective effects after a regional ischemia/reperfusion injury in an in vivo rat heart model

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Propofol Is Cardioprotective in a Clinically Relevant Model of Normothermic Blood Cardioplegic Arrest and Cardiopulmonary Bypass

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