Cardiovascular Toxicology

, Volume 17, Issue 2, pp 150–156 | Cite as

Safety Evaluation of Sevoflurane as Anesthetic Agent in Mouse Model of Myocardial Ischemic Infarction

  • Xiang Cheng
  • Jianglong Hou
  • Jiaming Liu
  • Xiaorong Sun
  • Qin Sheng
  • Pengfei Han
  • Y. James Kang
Article
  • 158 Downloads

Abstract

The selection of anesthetics for patients with myocardial infarction is critically challenging. Sevoflurane is a volatile anesthetic gradually used in recent years. The intraoperative hemodynamic stability of sevoflurane was supported by several studies with some suggestions for its use for patients with cardiac events. The present study was undertaken to investigate the effect of sevoflurane on mice with myocardial infarction to evaluate the safety issue of this agent for possible application in patients with myocardial infarction. Mice of 7–12 weeks old were subjected to left anterior descending artery ligation to introduce acute myocardial infarction. The effect of sevoflurane on the hemodynamics was examined in comparison with that of currently available agent etomidate at low and moderate doses. The results showed that sevoflurane caused unstable hemodynamic changes in mice with myocardial infarction at both low and moderate inhaled concentrations relative to low and moderate doses of etomidate. In addition, the relative safety margin estimated from therapeutic index was decreased by 50 % when sevoflurane was used for mice with myocardial infarction relative to control mice, but only decreased by 20 % for etomidate. These analyses indicate that in comparison with currently available agent etomidate, sevoflurane should not be applied to patients with myocardial infarction or other cardiac events.

Keywords

Sevoflurane Etomidate Safety Myocardial infarction Mice 

References

  1. 1.
    Djaiani, G. N., Hall, J., Pugh, S., & Peaston, R. T. (2001). Vital capacity inhalation induction with sevoflurane: An alternative to standard intravenous induction for patients undergoing cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 15, 169–174.CrossRefPubMedGoogle Scholar
  2. 2.
    Clivatti, J., Smith, R. L., Sermer, M., Silversides, C., & Carvalho, J. C. A. (2012). Cardiac output monitoring during Cesarean delivery in a patient with palliated tetralogy of Fallot. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 59, 1119–1124.CrossRefPubMedGoogle Scholar
  3. 3.
    Lee, H. M., Sung, H. S., & Kim, S. Y. (2011). Anesthetic management of non-cardiac surgery with adult onset type of cor triatriatum sinister -A case report. Korean Journal of Anesthesiology, 60, 444.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Rasmussen, K. G., Spackman, T. N., & Hooten, W. M. (2005). The clinical utility of inhalational anesthesia with sevoflurane in electroconvulsive therapy. The Journal of ECT, 21, 239–242.CrossRefPubMedGoogle Scholar
  5. 5.
    Hallay, J., Micskei, C., Kollar, S., Sz Kiss, S., & Fulesdi, B. (2008). Anaesthesia of the myasthenic patients during thymectomy. Magyar Sebészet, 61(Suppl), 37–40.CrossRefPubMedGoogle Scholar
  6. 6.
    Goodwin, N., Campbell, A. E., Hall, J. E., Plummer, S., & Harmer, M. (2004). A comparison of 8% and 12% sevoflurane for inhalation induction in adults. Anaesthesia, 59, 15–19.CrossRefPubMedGoogle Scholar
  7. 7.
    Calderon, E., Torres, L. M., Aguado, J. A., De Antonio, P., Mora, R., & Almarcha, J. M. (1998). Comparative study of sevoflurane and nitrous oxide versus halothane and nitrous oxide in pediatric anesthesia: Efficacy and hemodynamic characteristics during induction. Revista Espanola de Anestesiologia y Reanimacion, 45, 126–129.PubMedGoogle Scholar
  8. 8.
    Walpole, R., & Logan, M. (1999). Effect of sevoflurane concentration on inhalation induction of anaesthesia in the elderly. British Journal of Anaesthesia, 82, 20–24.CrossRefPubMedGoogle Scholar
  9. 9.
    Vidal, M. A., Calderon, E., Martinez, E., Pernia, A., & Torres, L. M. (2006). Comparison of 2 techniques for inhaled anesthetic induction with sevoflurane in coronary artery revascularization. Revista Espanola de Anestesiologia y Reanimacion, 53, 639–642.PubMedGoogle Scholar
  10. 10.
    Nathan, N., Vial, G., Benrhaiem, M., Peyclit, A., & Feiss, P. (2001). Induction with propofol target-concentration infusion vs. 8% sevoflurane inhalation and alfentanil in hypertensive patients. Anaesthesia, 56, 251–257.CrossRefPubMedGoogle Scholar
  11. 11.
    Peacock, J. E., Lewis, R. P., Reilly, C. S., & Nimmo, W. S. (1990). Effect of different rates of infusion of propofol for induction of anaesthesia in elderly patients. British Journal of Anaesthesia, 65, 346–352.CrossRefPubMedGoogle Scholar
  12. 12.
    Billard, V., Moulla, F., Bourgain, J. L., Megnigbeto, A., & Stanski, D. R. (1994). Hemodynamic response to induction and intubation. Propofol/fentanyl interaction. Anesthesiology, 81, 1384–1393.CrossRefPubMedGoogle Scholar
  13. 13.
    Zouggari, Y., Ait-Oufella, H., Bonnin, P., Simon, T., Sage, A. P., Guérin, C., et al. (2013). B lymphocytes trigger monocyte mobilization and impair heart function after acute myocardial infarction. Nature Medicine, 19, 1273–1280.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Korf-Klingebiel, M., Reboll, M. R., Klede, S., Brod, T., Pich, A., Polten, F., et al. (2015). Myeloid-derived growth factor (C19orf10) mediates cardiac repair following myocardial infarction. Nature Medicine, 21, 140–149.CrossRefPubMedGoogle Scholar
  15. 15.
    Eger, E. I, 2nd. (1993). New inhalational agents–desflurane and sevoflurane. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 40, R3–R8.CrossRefPubMedGoogle Scholar
  16. 16.
    Dai, A. L., Fan, L. H., Zhang, F. J., Yang, M. J., Yu, J., Wang, J. K., et al. (2010). Effects of sevoflurane preconditioning and postconditioning on rat myocardial stunning in ischemic reperfusion injury. Journal of Zhejiang University Science B, 11, 267–274.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Deyhimy, D. I., Fleming, N. W., Brodkin, I. G., & Liu, H. (2007). Anesthetic preconditioning combined with postconditioning offers no additional benefit over preconditioning or postconditioning alone. Anesthesia and Analgesia, 105, 316–324.CrossRefPubMedGoogle Scholar
  18. 18.
    Correia-Pinto, J., Henriques-Coelho, T., Magalhaes, S., & Leite-Moreira, A. F. (2004). Pattern of right ventricular pressure fall and its modulation by afterload. Physiological Research/Academia Scientiarum Bohemoslovaca, 53, 19–26.Google Scholar
  19. 19.
    Wallin, R. F., Regan, B. M., Napoli, M. D., & Stern, I. J. (1975). Sevoflurane: A new inhalational anesthetic agent. Anesthesia and Analgesia, 54, 758–766.CrossRefPubMedGoogle Scholar
  20. 20.
    Kikura, M., & Ikeda, K. (1993). Comparison of effects of sevoflurane/nitrous oxide and enflurane/nitrous oxide on myocardial contractility in humans. Load-independent and noninvasive assessment with transesophageal echocardiography. Anesthesiology, 79, 235–243.CrossRefPubMedGoogle Scholar
  21. 21.
    Bernard, J. M., Wouters, P. F., Doursout, M. F., Florence, B., Chelly, J. E., & Merin, R. G. (1990). Effects of sevoflurane and isoflurane on cardiac and coronary dynamics in chronically instrumented dogs. Anesthesiology, 72, 659–662.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Xiang Cheng
    • 1
    • 3
  • Jianglong Hou
    • 2
  • Jiaming Liu
    • 1
  • Xiaorong Sun
    • 1
  • Qin Sheng
    • 1
  • Pengfei Han
    • 1
  • Y. James Kang
    • 1
  1. 1.Regenerative Medicine Research Center, West China HospitalSichuan UniversityChengduChina
  2. 2.Department of Cardiovascular Surgery, West China HospitalSichuan UniversityChengduChina
  3. 3.Department of Anesthesiology and Pain Medicine, Affiliated Haikou Hospital of Xiangya Medical SchoolCentral South UniversityHaikouChina

Personalised recommendations