From the Department of Anesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany.
Institute of Cardiovascular Physiology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Anesth Analg. 2018 Apr;126(4):1377-1380. doi: 10.1213/ANE.0000000000002563.
Remote ischemic preconditioning (RIPC) seems to be a promising cardioprotective strategy with contradictive clinical data suggesting the anesthetic regimen influencing the favorable impact of RIPC. This study aimed to investigate whether cardio protection by RIPC is abolished by anesthetic regimens. Male Wistar rats were randomized to 6 groups. Anesthesia was either maintained by pentobarbital (Pento) alone or a combination of sevoflurane (Sevo) and remifentanil or propofol (Prop) and remifentanil in combination with and without RIPC. RIPC reduced infarct size in Pento- and Sevo-anesthetized rats (Pento-RIPC: 30% ± 9% versus Pento-control [Con]: 65% ± 6%, P < .001; Sevo-RIPC: 31% ± 6% versus Sevo-Con: 61% ± 8%, P < .001), but RIPC did not initiate cardio protection in Prop-anesthetized animals (Prop-RIPC: 59% ± 6% versus Prop-Con: 59% ± 8%, P = 1.000). Cardio protection by RIPC is abolished by Prop.
远程缺血预处理（RIPC）似乎是一种有前途的心脏保护策略，但临床数据相互矛盾，表明麻醉方案会影响 RIPC 的有利影响。本研究旨在探讨 RIPC 的心脏保护是否会被麻醉方案所消除。雄性 Wistar 大鼠被随机分为 6 组。麻醉单独维持用戊巴比妥（戊巴比妥）或七氟醚（七氟醚）和瑞芬太尼的组合或丙泊酚（丙泊酚）和瑞芬太尼的组合，并用或不用 RIPC。RIPC 可减少戊巴比妥和七氟醚麻醉大鼠的梗死面积（戊巴比妥-RIPC：30%±9%比戊巴比妥对照[Con]：65%±6%，P<0.001；七氟醚-RIPC：31%±6%比七氟醚对照[Con]：61%±8%，P<0.001），但 RIPC 不能在丙泊酚麻醉动物中引发心脏保护（丙泊酚-RIPC：59%±6%比丙泊酚对照[Con]：59%±8%，P=1.000）。RIPC 的心脏保护作用被丙泊酚消除。
