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ANESTHETIC PHARMACOLOGY

Sevoflurane Promotes Endothelium-Dependent Smooth Muscle Relaxation in Isolated Human Omental Arteries and Veins

Department of Anesthesia and Intensive Care, Lund University Hospital, Sweden

Address correspondence and reprint requests to Mikael Bodelsson, MD, PhD, Department of Anesthesia and Intensive Care, Lund University Hospital, SE-221 85 Lund, Sweden. Address e-mail to mikael.bodelsson{at}anest.lu.se

Anesthesia with sevoflurane is accompanied by vasodilatation. This could be due to the effects of sevoflurane on endothelium-dependent relaxation. We measured muscle tension of isolated human omental arteries and veins in response to substance P or glyceryl trinitrate in the presence of sevoflurane (0%, 1%, 2%, or 4%). Vascular levels of guanosine 3', 5'-cyclic monophosphate were measured with enzyme-linked immunosorbent assay. Substance P induced an endothelium- and concentration-dependent relaxation in omental vessels that was not affected by sevoflurane. In the presence of L-N^G-nitroarginine methyl ester (nitric oxide synthase inhibitor), KCl (prevention of hyperpolarization), or both, sevoflurane at 4% enhanced the relaxation in the arteries (P < 0.05). In the vein segments, the relaxation was enhanced by sevoflurane at 4% in the presence of KCl and 2% and 4% in the presence of both L-N^G-nitroarginine methyl ester and KCl (P < 0.05). The glyceryl trinitrate-induced endothelium-independent relaxation was enhanced by sevoflurane at 4% in both artery and vein segments (P < 0.05). Substance P increased the levels of guanosine 3', 5'-cyclic monophosphate similarly in the presence and absence of sevoflurane. These results show that sevoflurane, in contrast to its effect in animal models, promotes endothelium-dependent relaxation in human omental arteries and veins via an enhancement of the smooth muscle response to relaxing second messengers.

IMPLICATIONS: Anesthesia with sevoflurane is accompanied by vasodilatation. We studied the effects of sevoflurane on isolated human arteries and veins. In contrast to previous animal studies, our results show that sevoflurane at larger concentrations promotes endothelium-dependent vasodilatation via an enhancement of the vascular smooth muscle response to relaxing second messengers.

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