Organ Protective Effect of Isoflurane Anesthesia in Cardiac Surgeries with Artificial Circulation

The aim of the investigation is to give full estimation of organ protective effect of isoflurane anesthesia in cardiac surgeries with artificial circulation.

Materials and Methods. There were analyzed the results of clinical, functional, biochemical and morphological examinations of 424 patients operated under the conditions of artificial circulation using two variants of anesthesia: 203 patients were given isoflurane (experimental group); 221 patients — propofol (control group). There were studied clinical progression of rehabilitation period, the change of myocardial contractile function indices, myocardial ultrastructure, and biochemical blood values after the operation.

Conclusion. Isoflurane anesthesia provides an additional protective effect in cardiac surgeries with artificial circulation. This effect is proved by complex clinical studies regarding the heart, liver, and kidneys. Myocardial effect of additional protection is supported by clinical, functional, morphological, and biochemical criteria.

1. Minguer G., Joris J., Lamy M. Preconditioning and protection against ischaemia reperfusion in non cardiac organs: a place for volatile anaesthetics? Eur J Anaesth 2007; 24(9): 733–745.
2. Hu G., Salem M.R., Crystal G.J. Isoflurane prevents platelets from enhancing neutrophil-induced coronary endothelial dysfunction. Anesth Analg 2005; 101: 1261–1268.
3. Liu R., Ishibe Y., Ueda M. Isoflurane-sevoflurane administration before ischemia attenuates ischemia — reperfusion-induced injury in isolated rat lungs. Anesthesiology 2000; 92: 833–840.
4. Hoetzel A., Leitz D., Schmidt R., et al. Mechanism of hepatic heme oxygenase-1 induction by isoflurane. Anesthesiology 2006; 104: 101–109.
5. Patel A., van de Poll M.C., Greve J.W., et al. Early stress protein gene expression in a human model of ischemic preconditioning. Transplantation 2004; 78: 1479–1487.
6. Hashiguchi H., Morooka H., Miyoshi H., et al. Isoflurane protects renal function against ischemia and reperfusion through inhibition of protein kinases, JNK and ERK. Anesth Analg 2005; 101: 1584–1589.
7. Lee H.T., Ota-Setlik A., Fu Y., Nasr S.H., Emala C.W. Differential protective effects of volatile anesthetics against renal ischemia — reperfusion injury in vivo. Anesthesiology 2004; 101: 1313–1324.

Eldyrev А.Y., Medvedev А.P., Bober V.M., Bogush А.V., Yakovleva Е.I., Leckwantee Rittoo, Pichugin V.V. Organ Protective Effect of Isoflurane Anesthesia in Cardiac Surgeries with Artificial Circulation. Sovremennye tehnologii v medicine 2012; (4): 79