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CARDIOVASCULAR ANESTHESIA

Cardioprotection with Volatile Anesthetics: Mechanisms and Clinical Implications

Stefan G. De Hert, MD, PhD^*, Franco Turani, MD, Sanjiv Mathur, MD, and David F. Stowe, MD, PhD

*Department of Anesthesiology, University Hospital Antwerp, Edegem, Belgium; Department of Anesthesia and Intensive Care, European Hospital, University of Rome Tor Vergata, Rome, Italy; Department of Anesthesia and Critical Care, Sudbury Regional Hospital, Sudbury, Ontario, Canada; Departments of Anesthesiology and Physiology, The Medical College of Wisconsin, Department of Biomedical Engineering, Marquette University; Research Service, Veterans Affairs Medical Center, Milwaukee, Wisconsin

Address correspondence and reprint requests to Stefan G. De Hert, MD, PhD, Department of Anesthesiology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium. Address e-mail to stefan.dehert{at}ua.ac.be.

Cardiac surgery and some noncardiac procedures are associated with a significant risk of perioperative cardiac morbid events. Experimental data indicate that clinical concentrations of volatile general anesthetics protect the myocardium from ischemia and reperfusion injury, as shown by decreased infarct size and a more rapid recovery of contractile function on reperfusion. These anesthetics may also mediate protective effects in other organs, such as the brain and kidney. Recently, a number of reports have indicated that these experimentally observed protective effects may also have clinical implications in cardiac surgery. However, the impact of the use of volatile anesthetics on outcome measures, such as postoperative mortality and recovery in cardiac and noncardiac surgery, is yet to be determined.

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