Differential protective effects of anaesthesia with sevoflurane or isoflurane An animal experimental model simulating liver transplantation

作者：Dal Molin Silue Z F; Kruel Cleber R P^*; de Fraga Raquel S; Alboim Carolina; de Oliveira Jarbas R; Alvares da Silva Mario R

来源：European Journal of Anaesthesiology, 2014, 31(12): 695-700.

DOI：10.1097/EJA.0000000000000127

BACKGROUND The mechanisms involved in organ protection by volatile anaesthetics are not completely understood. In the liver transplant setting, there is a lack of information in the literature about whether sevoflurane anaesthesia has a superior hepatoprotective effect when compared with isoflurane.
OBJECTIVE To compare the antioxidant and protective effects of isoflurane and sevoflurane.
DESIGN A randomised, comparative, experimental study.
SETTING The study was performed in the Animal Experimentation Unit of Hospital de Clinicas de Porto Alegre, Brazil. Twenty male Wistar rats weighing between 350 and 450 g were randomly assigned to one of two groups.
INTERVENTION Each group consisted of 10 animals that were exposed to one of two different volatile anaesthetics (sevoflurane or isoflurane). In both groups, five rats were used as 'donors' and another five as 'recipients'. In order to evaluate the effects of each anaesthetic agent, the same anaesthetic technique was used during procurement and reperfusion operations.
MAIN OUTCOME MEASURES Samples of the preservation solution were collected during cold ischaemia to measure aminotransferase and lactate dehydrogenase (LDH) concentrations. After 15 min of reperfusion, blood samples were taken to measure the levels of aminotransferases, LDH and thiobarbituric acid reactive substances (TBARS). The concentrations of TBARS, catalase and nitric oxide derivatives were measured in the liver tissue after reperfusion.
RESULTS Rats in the sevoflurane group had significantly lower concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and LDH in the samples obtained from the preservative solution after 6 h of cold ischaemia (P<0.05). Serum TBARS concentrations were significantly lower in the group exposed to sevoflurane anaesthesia (P<0.001). There were no significant differences in the tissue concentrations of TBARS and catalase (P=0.089 and P=0.24, respectively). However, the concentration of nitric oxide was significantly higher in the liver tissue of the rats exposed to sevoflurane anaesthesia (P<0.05).
CONCLUSION These results suggest that sevoflurane anaesthesia seems to have superior protective and antioxidant effects to isoflurane anaesthesia, not only during cold preservation but also in the early phase of liver reperfusion.

• 出版日期2014-12