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CARDIOVASCULAR ANESTHESIA

Anesthetic Preconditioning with Sevoflurane Does Not Protect the Spinal Cord After an Ischemic-Reperfusion Injury in the Rat

David A. Zvara, MD^*, Andrew J. Bryant, BS^*, Dwight D. Deal, BS^*, Mario P. DeMarco, BS^*, Kevin M. Campos, BS^*, Carol M. Mansfield, BS, and Michael Tytell, PhD

Departments of *Anesthesiology and Neurobiology and Anatomy, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Address correspondence to David Zvara, MD, Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27127-1009. Address e-mail to dzvara{at}wfubmc.edu.

Anesthetic preconditioning (APC) is a protective mechanism, whereby exposure to a volatile anesthetic renders a tissue resistant to a subsequent ischemic insult. We hypothesized that APC of the rat spinal cord with sevoflurane would reduce neurologic deficit after an ischemic-reperfusion injury. Rats were randomly assigned to 1 of 5 groups. The ischemic preconditioning (IPC) group (n = 14) had 3 min of IPC, 30 min of reperfusion, and 12 min of ischemia. The chronic APC (cSEVO) group (n = 14) had 1 h of APC with 3.5% sevoflurane on each of 2 days before ischemia. The acute APC (aSEVO) group (n = 14) had 1 h of APC with 3.5% sevoflurane followed by a 1-h washout period before the induction of ischemia. The controls (n = 14) underwent no preconditioning before ischemia. IPC attenuated the ischemia-reperfusion injury, whereas aSEVO and cSEVO groups were no better than control animals. Histologic evaluation of the spinal cord showed severe neurologic damage in all groups except for the IPC group and sham-operated rats. APC with sevoflurane did not reduce neurologic injury in a rat model of spinal cord ischemia. Traditional ischemic preconditioning had a strong protective benefit on neurologic outcome.

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