Comparison of Cardioprotective Potency of Preconditioning by General Anesthetics Desflurane and Sevoflurane

Abstract

Anesthetic preconditioning (AP) is a phenomenon whereby transient exposure to volatile anesthetics (VA) can protect the heart from subsequent ischemic injury. Studies on a whole heart implied desflurane as the most potent cardiac protector among VA. The aim of the present study was to examine the protective efficacy of preconditioning by sevoflurane and desflurane in a clinical relevant concentrations. To exclude their potential influence on coronary flow and vasculature, we used isolated rat cardiomyocytes. Treatment with each anesthetic protected the cells from subsequent oxidative stress (combination of H2O2 and FeSO4). Cell viability was determined by cellular morphology analysis and trypan blue exclusion. Prior administration of desflurane and sevoflurane reduced the cell death by 34% and 15%, respectively. We also compared the effects of sevoflurane and desflurane on mitochondrial redox state by analyzing mitochondrial flavoproteins fluorescence (MFF). Treatment with each anesthetic resulted in an elevated MFF. Similar to survival experiments, the degree of flavoprotein oxidation was increased more by desflurane as compared to sevoflurane (68% vs. 41%, respectively). In conclusion, desflurane confers greater degree of cardiac protection then sevoflurane, and the mechanism likely includes anesthetic interaction with mitochondrial oxidative state. Supported by NIH (HL 34708 and GM 066730)