Nigro Neto Caetano, Tardelli Maria Angela, Paulista Paulo Henrique Dagola
Anesthesiology, Universidade Federal de São Paulo (UNIFESP), Rua Peixoto Gomide 502/173B, SP, Brazil.
Rev Bras Anestesiol. 2012 May-Jun;62(3):346-55. doi: 10.1016/S0034-7094(12)70135-6.
The use of volatile anesthetics in cardiac surgery is not recent. Since the introduction of halothane in clinical practice, several cardiac surgery centers started to use these anesthetics constantly.
In the last years a great number of studies have shown that the volatile anesthetics have a protecting effect against myocardial ischemic dysfunction. Experimental evidences have shown that the halogenated anesthetics have cardioprotective effects that cannot be only explained by coronary flow alterations or by the balance between myocardium available and consumed oxygen. In addition to that, the use of volatile anesthetics during extracorporeal circulation (ECC) in cardiac surgery plays an important role. Recent studies have proven that these agents have cardioprotective properties and produce better results when the volatile anesthetic is used during the whole surgery procedure, including ECC. The use of halogenated anesthetics through calibrated vaporizers adapted to the ECC circuit via oxygenator membranes has become popular. Therefore, the professionals involved such as anesthesiologists and perfusionists should learn specifics in order to solve possible doubts.
挥发性麻醉剂在心脏手术中的应用并非新鲜事。自氟烷引入临床实践以来，多个心脏手术中心开始持续使用这些麻醉剂。
在过去几年中，大量研究表明挥发性麻醉剂对心肌缺血性功能障碍具有保护作用。实验证据表明，卤化麻醉剂的心脏保护作用不能仅通过冠状动脉血流改变或心肌供氧量与耗氧量之间的平衡来解释。除此之外，挥发性麻醉剂在心脏手术体外循环（ECC）期间的使用也起着重要作用。最近的研究证明，这些药物具有心脏保护特性，并且在包括ECC在内的整个手术过程中使用挥发性麻醉剂时会产生更好的效果。通过经氧合器膜适配于ECC回路的校准蒸发器使用卤化麻醉剂已变得很普遍。因此，涉及的专业人员如麻醉医生和灌注师应了解具体细节以解决可能的疑问。
