Isoflurane and coronary heart disease

被引:16
作者
Agnew, NM [1 ]
Pennefather, SH [1 ]
Russell, GN [1 ]
机构
[1] Cardiothorac Ctr Liverpool NHS Trust, Dept Anaesthesia, Liverpool, Merseyside, England
关键词
anaesthetics; volatile; isoflurane; heart; coronary occlusion; ischaemia; myocardial function; blood flow (myocardial);
D O I
10.1046/j.1365-2044.2002.02469.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Early studies indicated that isoflurane caused coronary steal and should therefore be avoided in patients with coronary heart disease. Subsequently, more detailed trials have disputed this and have shown that as long as coronary perfusion pressure is maintained, isoflurane does not cause coronary steal or myocardial ischaemia. There is nov,, growing evidence, initially in animal work but more recently in human studies, that isoflurane has myocardial protective properties, limiting infarct size and improving functional recovery from myocardial ischaemia. The mechanism for this protection mimics ischaemic preconditioning and involves the opening of adenosine triphosphate-dependent potassium channels. The few, studies comparing the myocardial protection offered by individual anaesthetic agents indicate that isoflurane represents the anaesthetic agent of choice for patients with coronary heart disease.
引用
收藏
页码:338 / 347
页数:10
相关论文
共 68 条
[61]   BENEFICIAL-EFFECTS OF VOLATILE ANESTHETICS ON DECREASE IN CORONARY FLOW AND MYOCARDIAL-CONTRACTILITY INDUCED BY OXYGEN-DERIVED FREE-RADICALS IN ISOLATED RABBIT HEARTS [J].
TANGUAY, M ;
BLAISE, G ;
DUMONT, L ;
BEIQUE, G ;
HOLLMANN, C .
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 1991, 18 (06) :863-870
[62]  
Toller W G, 2000, Curr Opin Anaesthesiol, V13, P35, DOI 10.1097/00001503-200002000-00006
[63]   Isoflurane-enhanced recovery of canine stunned myocardium - Role for protein kinase C? [J].
Toller, WG ;
Montgomery, MW ;
Pagel, PS ;
Hettrick, DA ;
Warltier, DC ;
Kersten, JR .
ANESTHESIOLOGY, 1999, 91 (03) :713-722
[64]   Isoflurane preconditions myocardium against infarction via activation of inhibitory guanine nucleotide binding proteins [J].
Toller, WG ;
Kersten, JR ;
Gross, ER ;
Pagel, PS ;
Warltier, DC .
ANESTHESIOLOGY, 2000, 92 (05) :1400-1407
[65]   Ischemic preconditioning in humans -: Models, mediators, and clinical relevance [J].
Tomai, F ;
Crea, F ;
Chiariello, L ;
Gioffrè, PA .
CIRCULATION, 1999, 100 (05) :559-563
[66]   RECOVERY OF CONTRACTILE FUNCTION OF STUNNED MYOCARDIUM IN CHRONICALLY INSTRUMENTED DOGS IS ENHANCED BY HALOTHANE OR ISOFLURANE [J].
WARLTIER, DC ;
ALWATHIQUI, MH ;
KAMPINE, JP ;
SCHMELING, WT .
ANESTHESIOLOGY, 1988, 69 (04) :552-565
[67]   FUNCTIONAL RECOVERY OF STUNNED MYOCARDIUM IS GREATER WITH HALOTHANE THAN FENTANYL ANESTHESIA IN DOGS [J].
WHITE, JL ;
MYERS, AK ;
ANALOUEI, A ;
KIM, YD .
BRITISH JOURNAL OF ANAESTHESIA, 1994, 73 (02) :214-219
[68]  
徐军美, 1998, 湖南医科大学学报, V23, P489