Glantz L, Ginosar Y, Chevion M, Gozal Y, Elami A, Navot N, Kitrossky N, Drenger B
Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel.
Anesthesiology. 1997 Feb;86(2):440-7. doi: 10.1097/00000542-199702000-00019.
Recent studies indicate that during regional myocardial ischemia and subsequent reperfusion, volatile anesthetics may provide protection against free radical-related injury. The effect of halothane on free radical production during ischemia and reperfusion, in the canine heart, was investigated. The level of hydroxyl radical (.OH)-mediated conversion of salicylate to its dehydroxybenzoate derivatives (2,3-DHBA and 2,5-DHBA) was monitored.
Under general anesthesia, the heart was exposed through median sternotomy. Salicylate (100 mg/kg given intravenously) was administered 30 min before left anterior descending artery occlusion. Six dogs were studied using inhaled halothane (1.6%) 10 min before and during the 10-min ischemic period, followed by 50 min of reperfusion, and then they were compared with seven other dogs used as controls. Blood concentrations of salicylate, 2,3-DHBA and 2,5-DHBA, K+, lactate, oxygen content, and pH were monitored.
An acute increase in the normalized concentrations of 2,3-DHBA and 2,5-DHBA was observed in the control animals during reperfusion. In contrast, halothane inhalation completely inhibited the production of both metabolites (P < 0.02), but 2,5-DHBA concentrations in the halothane-treated group were even less than the basal level (P < 0.05). The increase in lactate concentrations in the experimental animals was significantly less than that of controls (P < 0.05) and followed the same time-dependent pattern as the changes in K+ and pH. Halothane significantly decreased (P < 0.0001) the difference in oxygen content between coronary sinus and aortic root blood, suggesting decreased oxygen utilization during reperfusion.
Halothane completely inhibited the production of .OH, and its administration may protect the heart from the deleterious effect of oxygen-derived reactive species, with attenuation of the metabolic response to ischemia.
近期研究表明,在局部心肌缺血及随后的再灌注过程中,挥发性麻醉剂可能对自由基相关损伤起到保护作用。本研究调查了氟烷对犬心脏缺血及再灌注过程中自由基产生的影响。监测了水杨酸经羟基自由基(·OH)介导转化为其脱氢苯甲酸衍生物(2,3 -二羟基苯甲酸和2,5 -二羟基苯甲酸)的水平。
在全身麻醉下,通过正中胸骨切开术暴露心脏。在左前降支动脉闭塞前30分钟静脉注射水杨酸(100毫克/千克)。对6只犬在缺血前10分钟及缺血10分钟期间使用吸入性氟烷(1.6%),随后进行50分钟再灌注,然后将其与另外7只作为对照的犬进行比较。监测水杨酸、2,3 -二羟基苯甲酸、2,5 -二羟基苯甲酸、钾离子、乳酸、氧含量和pH值的血药浓度。
在再灌注期间,对照动物中2,3 -二羟基苯甲酸和2,5 -二羟基苯甲酸的标准化浓度急剧增加。相比之下,吸入氟烷完全抑制了这两种代谢产物的产生(P < 0.02),但氟烷处理组中的2,5 -二羟基苯甲酸浓度甚至低于基础水平(P < 0.05)。实验动物中乳酸浓度的增加显著低于对照组(P < 0.05),并且与钾离子和pH值的变化遵循相同的时间依赖性模式。氟烷显著降低了(P < 0.0001)冠状窦血与主动脉根血之间的氧含量差异,表明再灌注期间氧利用率降低。
氟烷完全抑制了·OH的产生,其应用可能保护心脏免受氧衍生活性物质的有害影响,并减轻对缺血的代谢反应。