Pharmacological preconditioning: comparison of desflurane,sevoflurane, isoflurane and halothane in rabbit myocardium

Background. Recent investigations showed that isoflurane caninduce pharmacological preconditioning. The present study aimedto compare the potency of four different halogenated anaestheticsto induce preconditioning. Methods. Anaesthetized open-chest rabbits underwent 30 min ofcoronary artery occlusion followed by 3 h of reperfusion. Beforethis, rabbits were randomized into one of five groups and underwenta treatment period consisting of either no intervention for45 min (control; n=10), or 30 min of 1 MAC halogenated anaestheticinhalation followed by 15 min of washout. End-tidal concentrationsof halogenated agents were 3.7% for sevoflurane (n=11), 1.4%for halothane (n=9), 2.0% for isoflurane (n=11), and 8.9% fordesflurane (n=11). Area at risk and infarct size were assessedby blue dye injection and tetrazolium chloride staining. Results. Mean (SD) infarct size was 54 (18)% of the risk areain untreated controls and 40 (18)% in the sevoflurane group(P>0.05, ns). In contrast, mean infarct size was significantlysmaller in the halothane, isoflurane, and desflurane groups:26 (18)%, 32 (18)% and 16 (17)%, respectively (P<0.05 vscontrol). Conclusions. Halothane, isoflurane and desflurane induced pharmacologicalpreconditioning, whereas sevoflurane had no significant effect.In this preparation, desflurane was the most effective agentat preconditioning the myocardium against ischaemia. Br J Anaesth 2002; 89: 486–91