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From the *Department of Anesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, People’s Republic of China; and Department of Anesthesiology, State Key Laboratory of Biotherapy of Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, Sichuan, People’s Republic of China.
Address correspondence and reprint requests to Yanlin Wang, MB, Professor and Chairman, Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China, or Jin Liu, MD, Professor and Chairman, Department of Anesthesiology, State Key Laboratory of Biotherapy of Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, Sichuan, China. Address e-mail to wangyanlin0510{at}yahoo.com or wuliujin{at}china.com.
Abstract
BACKGROUND: In this study, we examined the cardioprotective effects of parental emulsified isoflurane compared with inhaled isoflurane.
METHODS: Thirty-two rabbits were subjected to 30 min of myocardial ischemia induced by temporary ligation of the left anterior descending coronary artery followed by 3 h of reperfusion. Before left anterior descending coronary artery occlusion, the rabbits were randomly allocated into one of four groups (eight for each group): group C, no ischemia preconditioning treatment; group IS, inhaled isoflurane 1.1% end-tidal; group EI, a continuous infusion of 8% emulsified isoflurane to an end-tidal concentration of 0.64%; and group IN, a continuous infusion of 30% Intralipid® started 30 min. Treatments were started 30 min before ischemia followed by a 15 min washout period for isoflurane groups. Myocardial infarct volume, lactate dehydrogenase, and creatine kinase levels were measured and changes in mitochondrial ultrastructure assessed after 3 h myocardial reperfusion.
RESULTS: Myocardial infarct size 3 h after reperfusion was lower in groups IS and EI compared with groups C and IN (20% ± 8%, 18% ± 8%, 39% ± 6%, and 34% ± 9%, respectively, P < 0.01). There were no differences in myocardial infarct size between groups IS and EI or between groups C and IN. Plasma lactate dehydrogenase and creatine kinase levels were lower in group IS (456 ± 58 U/L and 1725 ± 230 U/L) and group EI (451 ± 54 U/L and1686 ± 444 U/L) 3 h after myocardial reperfusion compared with groups C (676 ± 82 U/L and 2373 ± 529 U/L; P < 0.01). Mitochondrial ultrastructure changes were less pronounced in groups IS and EI compared with group C.
CONCLUSIONS: Our results indicate that, in rabbits, IV emulsified isoflurane provides similar myocardial protection against ischemia-reperfusion injury as inhaled isoflurane.
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  E. Lucchinetti, M. C. Schaub, and M. Zaugg Emulsified Intravenous Versus Evaporated Inhaled Isoflurane for Heart Protection: Old Wine in a New Bottle or True Innovation? Anesth. Analg., May 1, 2008; 106(5): 1346 - 1349. [Full Text] [PDF]
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