Baumert Jan-H, Hein Marc, Gerets Christina, Baltus Thomas, Hecker Klaus E, Rossaint Rolf
Klinik fuer Anaesthesiologie, University Clinic, Aachen, Germany.
Anesth Analg. 2007 Nov;105(5):1200-6, table of contents. doi: 10.1213/01.ane.0000284697.73471.9c.
Volatile anesthetics protect the myocardium from ischemia reperfusion damage. Our hypothesis for this study was that xenon reduces the size of myocardial infarction similar in extent to the reduction associated with ischemic preconditioning.
Thirty-six pigs weighing 30-35 kg were anesthetized with thiopental and then randomized into four groups: control (myocardial ischemia only), ischemic preconditioning (five 5-min episodes of intermittent myocardial ischemia), xenon preconditioning (three 10-min exposures to xenon 70% followed by myocardial ischemia), and xenon anesthesia (xenon 70%, continued before and after myocardial ischemia). Myocardial ischemia was induced by placing a tourniquet around the left anterior descending coronary artery for 60 min followed by 2 h of reperfusion. Myocardial infarct size and the area at risk for myocardial infarction were measured by Evans Blue and triphenyl tetrazolium chloride staining, respectively.
Mean (sd) myocardial infarct size was reduced from 64% +/- 9% of the area at risk in the control group to 19% +/- 12% with ischemic preconditioning (P < 0.001), and to 50% +/- 9% with xenon anesthesia (P < 0.05 versus control, P < 0.001 versus ischemic preconditioning). Myocardial infarct size was not reduced with xenon preconditioning compared with the control group (59% +/- 11%, P = 0.41).
Myocardial infarct size was reduced by ischemic preconditioning but less so by xenon anesthesia. Brief, intermittent exposure to xenon before myocardial ischemia did not reduce myocardial infarct size.
挥发性麻醉剂可保护心肌免受缺血再灌注损伤。我们本研究的假设是，氙气可减小心肌梗死面积，其程度与缺血预处理相关的减小程度相似。
36只体重30 - 35千克的猪用硫喷妥钠麻醉，然后随机分为四组：对照组（仅心肌缺血）、缺血预处理组（五次5分钟的间歇性心肌缺血发作）、氙气预处理组（三次暴露于70%氙气10分钟，随后进行心肌缺血）和氙气麻醉组（70%氙气，在心肌缺血前后持续使用）。通过在左前降支冠状动脉周围放置止血带60分钟，然后再灌注2小时来诱导心肌缺血。分别用伊文思蓝和氯化三苯基四氮唑染色测量心肌梗死面积和心肌梗死危险区面积。
对照组心肌梗死面积平均（标准差）占危险区面积的64%±9%，缺血预处理组降至19%±12%（P < 0.001），氙气麻醉组降至50%±9%（与对照组相比P < 0.05，与缺血预处理组相比P < 0.001）。与对照组相比，氙气预处理组心肌梗死面积未减小（59%±11%，P = 0.41）。
缺血预处理可减小心肌梗死面积，氙气麻醉的效果则较差。心肌缺血前短暂、间歇性暴露于氙气并未减小心肌梗死面积。
