Department of Pathophysiology, "Victor Babeş", University of Medicine and Pharmacy of Timişoara, Timişoara, Romania.
Fundam Clin Pharmacol. 2013 Feb;27(1):21-34. doi: 10.1111/j.1472-8206.2012.01055.x. Epub 2012 Jul 15.
Volatile anaesthetics emerged as important cardioprotective agents in both animal models of ischaemia/reperfusion injury and humans with coronary artery disease. Their administration before a prolonged ischaemic episode is known as anaesthetic preconditioning, whereas when given at the very onset of reperfusion, the strategy is termed anaesthetic postconditioning. Both types of anaesthetic conditioning reduce, albeit not to the same degree, the extent of myocardial injury. They share similar, albeit not identical, intracellular signal transduction pathways with their widely investigated counterparts, ischaemic pre- and postconditioning. Despite a wealth of preclinical evidence for cardioprotection for anaesthetic conditioning strategies, their translation into clinical therapy has been rather disappointing. This review highlights the major findings on the cardioprotective effects of volatile anaesthetics in experimental settings. It explores hypotheses that may explain the lack of efficacy observed in several past clinical studies paving the way for future preclinical and translational studies.
挥发性麻醉剂在缺血/再灌注损伤的动物模型和患有冠状动脉疾病的人类中都成为了重要的心脏保护剂。在长时间缺血发作之前给予这些药物被称为麻醉预处理，而在再灌注开始时给予这些药物，则被称为麻醉后处理。这两种类型的麻醉预处理都能减轻心肌损伤的程度，尽管程度不尽相同。它们与广泛研究的缺血预处理和后处理具有相似的、但不完全相同的细胞内信号转导途径。尽管有大量关于麻醉预处理策略的心脏保护作用的临床前证据，但它们在临床治疗中的转化却相当令人失望。这篇综述强调了挥发性麻醉剂在实验环境中对心脏保护作用的主要发现。它探讨了一些假说，这些假说可以解释过去的几项临床研究中观察到的疗效缺失，为未来的临床前和转化研究铺平了道路。
