British Journal of Anaesthesia, Vol 76, Issue 6 860-867, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
W. Schlack, M. Hollmann, J. Stunneck and V. Thamer
Several studies have reported a protective effect of halothane on
myocardial injury in an ischaemia-reperfusion situation. It is unclear if
the protection is a result of the haemodynamic effects of halothane or if
halothane has a specific action on ischaemia or reperfusion
pathomechanisms. To examine this question, we have used an isolated rat
heart model where heart rate (300 beat min-1), ventricular volume and
coronary flow are constant. Left ventricular developed pressure (LVDP) and
release of creatine kinase (CK) were measured as variables of myocardial
performance and cellular injury, respectively. Five control hearts were
subjected to 35 min of low-flow (2 ml min-1) anoxic and substrate-free
perfusion and were then perfused for 1 h with the oxygenated buffer. In the
treatment groups, halothane 0.4 mmol litre-1 was added during the first 30
min of anoxic perfusion (n = 5) or during the first 30 min of reoxygenation
(n = 5). In five additional hearts, the effect of halothane 0.4 mmol
litre-1 was tested under normoxic conditions. Mean basal CK release was
0.29 (SEM 0.13) iu g-1 min-1 and LVDP was 105.5 (4.0) mm Hg. Under normoxic
conditions, halothane reduced LVDP to 52.0 (2.6) mm Hg. In control hearts,
the major cell injury occurred at the onset of reoxygenation (CK release
increased to 149.1 (9.1) iu g-1 min-1) and functional recovery after 1 h of
reoxygenation was poor (control LVDP, 14.2(2.)% of baseline). Halothane
during anoxia attenuated myocardial injury only moderately (CK release
50.2(5.7) iu g-1 min-1) and LVDP recovered to 30.8(3.0)% (each P < 0.05
vs control). When halothane was administered at reoxygenation, CK release
was reduced to 10.1 (0.9) iu g-1 min-1 and LVDP recovered to 69.4(4.9)%
(each P < .05 vs control). We conclude that halothane not only
attenuated ischaemic injury but had a specific protective action against
reoxygenation injury.
LABORATORY INVESTIGATIONS
Effect of halothane on myocardial reoxygenation injury in the isolated rat heart
Institut fur Klinische Anaesthesiologie, Heinrich-Heine-Universitat, Dusseldorf, Germany; Physiologisches Institut I, Heinrich-Heine-Universitat, Dusseldorf, Germany
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