Wednesday, 9 February 2022

Study on the Effects of Sevoflurane and Propofol on Reperfusion after Partial Thoracic Aortic Cross-Clamping: Is Sevoflurane Superior to Propofol in Relation to Blood Flow and Markers of Tissue Injury and Inflammation? | Chapter 10 | Issues and Developments in Medicine and Medical Research Vol. 4

 Background: Aortic clamping causes ischemia-reperfusion syndrome, hemodynamic implications, and alterations in serum indicators of cellular injury like pro-/anti-inflammatory cytokines release and oxygen free radicals. Sevoflurane and propofol are frequently used during cardiovascular surgery. Sevoflurane has been shown to be superior to propofol in ischemia caused by total occlusion of the thoracic aorta (sevoflurane has better hemodynamic stability and lower release of markers of tissue injury), but its effect in partial cross-clamping has not been studied. The goal of this research was to see how sevoflurane and propofol affected organ blood flow following partial thoracic aortic cross-clamping.

Ten healthy mini-pigs were divided into two groups (5 each) based on the type of anaesthetic used (sevoflurane or propofol). The ascending thoracic aorta was partially cross-clamped for 20 minutes after a median sternotomy. At baseline (before partial aortic cross-clamping) and 30 minutes after the partial aortic cross-clamping was removed, organ blood flow (measured using coloured microspheres), serum markers of tissue injury, markers of inflammation, atrial peptide natriuretic peptide, and nitric oxide were all measured.

There were no significant differences in blood flow in the brain (both frontal lobes), heart (both ventricles), liver, lung, kidney, or ileum after 30 minutes of reperfusion. Tissue damage, inflammation, and nitric oxide indicators were similar in both groups.

Conclusions: After partial cross-clamping of the thoracic aorta, sevoflurane is not superior than propofol in terms of blood flow, markers of tissue injury, markers of inflammation, and nitric oxide.

Study organ blood flow (measured by coloured microspheres), serum markers of tissue injury, markers of inflammation, atrial peptide natriuretic and nitric oxide at baseline (before partial aortic cross-clamping) and 30 minutes after partial aortic cross-clamping removal in ten healthy mini-pigs who were block-randomized to receive either propofol in continuous perfusion or sevoflurane as anaesthetic maintenance.

Author(S) Details

Paloma Morillas-Sendin
Department of Anesthesiology and Intensive Care, Gregorio Marañón University General Hospital, Madrid, Spain and Sanitary Research Institute Gregorio Marañón, Madrid, Spain.

Juan Francisco del Cañizo
Sanitary Research Institute Gregorio Marañón, Madrid, Spain and Department of Experimental Medicine and Surgery, Gregorio Marañón University General Hospital, Madrid, Spain and Department of Surgery, Faculty of Medicine, Complutense University of Madrid, Spain.

Manuel Ruiz
Department of Experimental Medicine and Surgery, Gregorio Marañón University General Hospital, Madrid, Spain and Department of Surgery, Faculty of Medicine, Complutense University of Madrid, Spain and Department of Cardiac Surgery, Gregorio Marañón University General Hospital, Madrid, Spain.

Emilio Delgado-Baeza
Sanitary Research Institute Gregorio Marañón, Madrid, Spain and Department of Experimental Medicine and Surgery, Gregorio Marañón University General Hospital, Madrid, Spain.

Begoña Quintana-Villamandos
Department of Anesthesiology and Intensive Care, Gregorio Marañón University General Hospital, Madrid, Spain and Sanitary Research Institute Gregorio Marañón, Madrid, Spain and Department of Pharmacology and Toxicology, Faculty of Medicine, Complutense University of Madrid, Spain.

View Book:- https://stm.bookpi.org/IDMMR-V4/article/view/5547

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