Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Organoprotection by sevoflurane in cardiosurgical patients

Authors: G.V. Yudin

Company:
Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2017-14-3-125-130

UDC: 615.211:616.12-089

Link: Clinical Physiology of Blood Circulaiton. 2017; 14 (3): 125-130

Quote as: Yudin G.V. Оrganoprotection by sevoflurane in cardiosurgical patients. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2017; 14 (3): 125–30 (in Russ.). DOI: 10.24022/1814- 6910-2017-14-3-125-130

Received / Accepted:  16.05.2017/ 21.06.2017

Full text:  

Abstract

To date, sevoflurane has established itself as an effective anesthetic with minimal side effects, with significant potential application in cardiac surgery. This review describes its protective properties, in particular the mechanisms of pharmacological preconditioning of the myocardium, antiapoptotic, antioxidant and antiinflomatory effects. The results of experimental works demonstrate the possibility of protection by sevoflurane of lung tissue and vascular endothelium when they are damaged. The data of several clinical trials and meta-analyses about benefits of sevoflurane before total intravenous anesthesia in cardiosurgical patients are presented. A different view on the clinical efficacy of organ protection with sevoflurane is set out .

References

1. Цыпин Л.Е., Лазарев В.В., Прокопьев Г.Г., Жирко-
ва Ю.В., Ваганов Н.Н., Бологов А.А. и др. Ингаля-
ционный наркоз севофлураном у детей: Учебно-
методическое пособие для врачей. М.; 2011: 20–7.
[Tsypin L.E., Lazarev V.V., Prokop'ev G.G., Zhirkova
Yu.V., Vaganov N.N., Bologov А.А. et al. Inhalation
anesthesia with sevoflurane in children: educationalmethodical
manual for physicians. Moscow; 2011:
20–7 (in Russ.).]
2. Laver D.R., Attia J., Oldmeadow C., Quail A.W.
Cardiac calcium release channel (ryanodine receptor 2)
regulation by halogenated anesthetics. Anesthesiology.
2017; 126 (3): 495–506.
3. Wang C., Xie H., Liu X., Qin Q., Wu X., Liu H., Liu C.
Role of nuclear factor-kB in volatile anaesthetic preconditioning
with sevoflurane during myocardial
ischaemia/reperfusion. Eur. J. Anaesthesiol. 2010; 27
(8): 747–56.
4. Lai J., Zhang L., Wang H., Lin P., Chen W. Effects of
sevoflurane preconditioning on cardiomyocyte apoptosis
and myocardial inflammation in rats with sepsis.
J. South. Med. Univer. 2014; 34 (11): 1680–3.
5. Yang X.L., Wang D., Zhang G.Y., Guo X.L. Comparison
of the myocardial protective effect of sevoflurane
versus propofol in patients undergoing heart valve
replacement surgery with cardiopulmonary bypass.
BMC Anesthesiology. 2017; 17 (1): 37.
6. Jovic M., Stancic A., Nenadic D., Cekic O., Nezic D.,
Milojevic P. et al. Mitochondrial molecular basis of
sevoflurane and propofol cardioprotection in patients
undergoing aortic valve replacement with cardiopulmonary
bypass. Cell. Physiol. Biochem. 2012; 29 (1):
131–42.
7. Wang L., Ye Y., Su H.B., Yang J.P. The anesthetic agent
sevoflurane attenuates pulmonary acute lung injury by
modulating apoptotic pathways. Brazil. J. Med. Biol.
Res. 2017; 20 (3): 5747.
8. Watanabe K., Iwahara C., Nakayama H., Iwabuchi K.,
Matsukawa T., Yokoyama K. et al. Sevoflurane suppresses
tumour necrosis factor-α-induced inflammatory
responses in small airway epithelial cells after
anoxia/reoxygenation. Br. J. Anaesth. 2013; 110 (4):
637–45.
9. Casanova J., Simon C., Vara E., Sanchez G., Rancan L.,
Abubakra S. et al. Sevoflurane anesthetic preconditioning
protects the lung endothelial glycocalyx
from ischemia reperfusion injury in an experimental
lung autotransplant model. J. Anesth. 2016; 30 (5):
755–62.
10. Annecke T., Chappel D., Chen C., Jacob M.,
Welsch U., Sommerhoff C.P. et al. Sevoflurane
preserves the endothelial glycocalyx against ischaemia–
reperfusion injury. Br. J. Anaesth. 2010; 104 (4):
414–21.
11. Graham M.D., Bru-Mercier G., Hopkins P.M.,
Harrison S.M. Transient and sustained changes in
myofilament sensitivity to Ca2+contribute to the
inotropic effects of sevoflurane in rat ventricle. Br. J.
Anaesth. 2005; 94 (3): 279–86.
12. Li F., Yuan Y. Meta-analysis of the cardioprotective
effect of sevoflurane versus propofol during cardiac surgery.
BMC Anesthesiol. 2015; 24 (15): 128.
13. Liu X., Liu X., Wang R., Luo H., Qin G., Wang L.U.
et al. Circulating microRNAs indicate cardioprotection
by sevoflurane inhalation in patients undergoing offpump
coronary artery bypass surgery. Exp. Ther. Med.
2016; 11 (6): 2270–6.
14. Ramirez M., Guerrero-Orriach J., Galan M., Iglesias
P., Rubio M., Bellido I., Cruz J. Cardioprotective
effect of sevoflurane vs. propofol during anaesthesia
and postoperative period in off-pump coronary
artery bypass graft surgery. Eur. J. Anaesthesiol. 2014; 1
(31): 75–6.
15. Bassuoni A.S., Amr Y.M. Cardioprotective effect of
sevoflurane in patients with coronary artery disease
undergoing vascular surgery. Saudi J. Anaesthesiol.
2012; 6 (2): 125–30.
16. Likhvantsev V.V., Landoni G., Levikov D.I.,
Grebenchikov O.A., Skripkin Y.V., Cherpakov R.A.
Sevoflurane versus total intravenous anesthesia for isolated
coronary artery bypass surgery with cardiopulmonary
bypass: a randomized trial. J. Cardiothorac.
Vasc. Anesth. 2016; 30 (5): 1221–7.
17. Zakharov V., Hussain A., Smetkin A., Kirov M.
Comparison of sevoflurane and propofol anesthesia
during off-pump coronary artery bypass grafting: effects
on cerebral oxygenation and cognitive function. Eur. J.
Anaesthesiol. 2014; 31: 120.
18. Ballester M., Lorens J., Garcia-de-la-Asuncion J.,
Perez-Griera J., Tebar E., Martinez-Leon J. et al.
Myocardial oxidative stress protection by sevoflurane
vs. propofol: a randomised controlled study in patients
undergoing off-pump coronary artery bypass graft surgery.
Eur. J. Anaesthesiol. 2011; 28 (12): 874–81.
19. Cromheecke S., Pepermans V., Hendrickx E.,
Lorsomradee S., Ten Broecke P.W., Stockman B.A.
et al. Cardioprotective properties of sevoflurane in
patients undergoing aortic valve replacement with cardiopulmonary
bypass. Anesth. Analg. 2006; 103 (2):
289–96.
20. Zhang F., Chen G., Chen C., Yan M. Sevoflurane postconditioning
converts persistent ventricular fibrillation
into regular rhythm. Eur. J. Anaesthesiol. 2009; 26 (9):
766–71.
21. Wang Q., Li Y.H., Wang T.L., Feng H., Cai B.
Protective effect of low-dose sevoflurane inhalation and
propofol anesthesia on the myocardium after carotid
endarterectomy: a randomized controlled trial. Chinas
Med. J. (Engl). 2015; 128 (14): 1862–6.
22. Nitzschke R., Wilgusch J., Kersten J.F., Trepte C.J.,
Haas S.A., Reuter D.A. et al. Changes in sevoflurane
plasma concentration with delivery through the oxygenator
during on-pump cardiac surgery. Br. J. Anaesth.
2013; 110 (6): 957–65.
23. Nigro Neto C., Arnoni R., Smaili Rida B., Landoni G.
Randomized trial on the effect of sevoflurane on
polypropylene membrane oxygenator performance.
J. Cardiothorac. Vasc. Anesth. 2013; 27 (5): 903–7.
24. Tan Z., Zhou L., Qin Z., Luo M., Chen H., Xiong J.
et al. Dose sevoflurane may reduce blood loss and need
for blood products after cardiac surgery: a prospective,
randomized pilot study. Medicine (Baltimore). 2016;
95 (17): 3424.
25. Guсlu C.Y., Unver S., Ayсinli B., Kazanci D., Dilber
E., Ozgok A. The effect of sevoflurane vs. TIVA on
cerebral oxygen saturation during cardiopulmonary
bypass–randomized trial. Adv. Clin. Exp. Med. 2014; 23
(6): 919–24.
26. Kosmac N., Knezeviс I., Vidmar G., Virag M., Ristiс
V. No difference in release of troponin I between
sevoflurane and propofol anaesthetic regimes in offpump
myocardial revascularization. Eur. J. Anaesthesiol.
2015; 29 (2): 843–4.
27. Landoni G., Calabro G.M., Marchetti C., Bignami E.,
Scandroglio A.M. Desflurane versus propofol in
patients undergoing mitral valve surge
28. Soro M., Gallego L., Silva V., Ballester M.T., Lorens J.,
Alvarino A. Cardioprotective effect of sevoflurane and
propofol during anaesthesia and the postoperative period
in coronary bypass graft surgery: a double-blind randomised
study. Eur. J. Anaesthesiol. 2012; 29 (12): 561–9.
29. Mahdavi L., Abdollahi M.H., Entezari A., Salehi E.,
Hosseini H., Moshtaghioon S.H. The effect of sevoflurane
versus propofol anesthesia on troponin I after congenital
heart surgery, a randomized clinical trial. Adv.
Clin. Exp. Med. 2015; 11 (4): 86.
30. Bettex D.A., Wanner P.M., Bosshart M., Balmer C.,
Knirsch W., Dave H. et al. Role of sevoflurane in organ
protection during cardiac surgery in children: a randomized
controlled trial. Interact. Cardiovasc. Thorac.
Surg. 2015; 20 (2): 157–65.
31. Xiong H.Y., Liu Y., Shu D.C., Zhang S.L., Qian X.,
Duan W.X. et al. Effects of sevoflurane inhalation during
cardiopulmonary bypass on pediatric patients: a
randomized controlled clinical trial. ASAIO J. 2016;
62 (1): 63–8.
32. Landoni G., Guarracino F., Cariello C., Franco A.,
Baldassarri R., Borghi G. et al. Volatile compared with
total intravenous anaesthesia in patients undergoing
high-risk cardiac surgery: a randomized multicentre
study. Br. J. Anaesth. 2014; 113 (6): 955–63.
33. Bonvini J.M., Beck-Schimmer B., Kuhn S.J.,
Graber S.M., Neff T.A., Schlapfer M. Late post-conditioning
with sevoflurane after cardiac surgery – are
surrogate markers associated with clinical outcome?
PLOS ONE. 2015; 10 (7).
34. Kwon W.K., Sung T.Y., Yu G.Y., Sidik H., Kang W.S.,
Lee Y., Kim T.Y. Effects of sevoflurane increments on
left ventricular systolic long-axis performance during
sevoflurane-remifentanil anesthesia for cardiovascular
surgery. J. Anesth. 2016; 30 (2): 223–31.
35. Landoni G., Greco T., Biondi-Zoccai G., Nigro Neto C.,
Febres D., Pintaudi M. et al. Anaesthetic drugs and survival:
a Bayesian network meta-analysis of randomized
trials in cardiac surgery. Br. J. Anaesth. 2013; 111 (6):
886–96.
36. Landoni G., Pasin L., Cabrini L., Scandroglio A.M.,
Redaelli M.B., Votta C.D. Volatile agents in medical
and surgical intensive care units: a meta-analysis of randomized
clinical trials. J. Cardiothorac. Vasc. Anesth.
2016; 30 (4): 1005–14.
37. Annecke T., Kubitz J.C., Kahr S., Hilberath J.M.,
Langer K., Kemming G.I. et al. Effects of sevoflurane
and propofol on ischaemia–reperfusion injury after
thoracic-aortic occlusion in pigs. Br. J. Anaesth. 2007;
98 (5): 581–90.
38. Ebel D., Preckel B., You A., Mullenheim J.,
Schlackl W., Thamer V. Cardioprotection by sevoflurane
against reperfusion injury after cardioplegic arrest
in the rat is independent of three types of cardioplegia.
Br. J. Anaesth. 2002; 88 (6): 828–35.
39. Landoni G., Biondi-Zoccai G.G., Zangrillo A.,
Bignami E., D'Avolio S., Marchetti C. et al. Desflurane
and sevoflurane in cardiac surgery: a meta-analysis of
randomized clinical trials. J. Cardiothorac. Vasc. Anesth.
2007; 21 (4): 502–11.

About Authors

Yudin Gennadiy Vyacheslavovich, Anesthesiologist-Intensivist; orcid.org/ 0000-0001-9976-6206

 If you found mistakes, select text and press Alt+A