Department of Anesthesiology, University Clinic, Aachen, Germany.
J Cardiothorac Vasc Anesth. 2009 Oct;23(5):614-8. doi: 10.1053/j.jvca.2009.01.028. Epub 2009 Apr 10.
To investigate if the protective effects of xenon and isoflurane against myocardial ischemia-reperfusion damage would be additive.
A prospective, randomized laboratory investigation.
An animal laboratory of a university hospital.
Thirty-six pigs (female German landrace).
In an open-chest preparation with thiopental anesthesia, the left anterior descending artery was occluded to produce ischemia for 60 minutes. One hour previously, ischemic preconditioning, isoflurane (0.55 minimum alveolar concentration [MAC]) alone, or isoflurane together with xenon (0.55 MAC each) were started in the respective groups. A fourth (control) group received no protective intervention. Myocardial ischemia was followed by 2 hours of reperfusion.
Hearts were excised and stained (Evans Blue/TTC) to measure infarct size as related to the area at risk. Myocardial infarct size was reduced (means +/- standard deviation) from 64% +/- 9% of the area at risk in the control group to 19% +/- 12% with ischemic preconditioning to 46% +/- 12% with isoflurane and to 39% +/- 13% with isoflurane and xenon. All intervention groups were significantly different from the control (p < 0.05), and both anesthetic groups were significantly different from ischemic preconditioning (p < 0.05).
Combined isoflurane/xenon anesthesia reduced infarct size but not more than isoflurane alone. Ischemic preconditioning was more effective than the anesthetics.
研究氙气和异氟烷对心肌缺血再灌注损伤的保护作用是否具有相加作用。
前瞻性、随机实验室研究。
一家大学医院的动物实验室。
36 头猪（雌性德国长白猪）。
在开胸、硫喷妥钠麻醉的情况下，结扎左前降支动脉造成 60 分钟心肌缺血。缺血预处理、异氟烷（0.55 最低肺泡有效浓度[MAC]）或异氟烷加氙气（各 0.55 MAC）在各自的组中 1 小时前开始。第四组（对照组）未接受任何保护干预。心肌缺血后继以 2 小时再灌注。
取出心脏并染色（伊文思蓝/TTC）以测量与危险区相关的梗死面积。与对照组（危险区的 64% +/- 9%）相比，缺血预处理组心肌梗死面积减少至 19% +/- 12%，异氟烷组减少至 46% +/- 12%，异氟烷加氙气组减少至 39% +/- 13%。所有干预组与对照组相比差异均有统计学意义（p < 0.05），且两组麻醉组与缺血预处理组相比差异均有统计学意义（p < 0.05）。
联合应用异氟烷/氙气麻醉可减少梗死面积，但不如异氟烷单独应用效果显著。缺血预处理比麻醉更有效。
