MECHANISMS OF CARDIOPROTECTIVE EFFECTS OF DESFLURANE AND SEVOFLURANE DURING REPERFUSION
Keywords:
desflurane, sevoflurane, reperfusion, postconditioning, preconditioning, reperfusion injury, extracorporeal circulationAbstract
Myocardial conditioning is actually an important strategy in the management of ischemic reperfusion injury. The concept of postconditioning anesthetic is intriguing, its action occurs at a key moment (reperfusion, when ischemic reperfusion lesions are initiated), when activation of these cardioprotective mechanisms can overpower the mechanisms leading to ischemic reperfusion injuries. Desflurane and sevoflurane are volatile anesthetics often used during cardiac surgery. This review focuses on the efficacy of desflurane and sevoflurane administered during early reperfusion as a potential cardioprotective strategy. The mechanisms underlying the cardioprotective action of these agents and their ability to induce postconditioning have been discussed in detail, highlighting the role of reactive oxygen species generation, activation of cellular signaling pathways, and action on mitochondria. This may well be enough to revive the basis for the launch of the randomized clinical trials that are really needed to confirm that this strategy has real impact.
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Advance Access published on June 9, pii: 0267659115590833
