Volatile Anesthetics and Cardiac Function
Volatile Anesthetics and Cardiac Function
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DOI：
10.1177/108925320601000107
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发表时间：
2006-03-01
影响因子：
1.4
通讯作者：
De Hert, Stefan G.
中科院分区：
文献类型：
--
作者：
De Hert, Stefan G.
所有挥发性麻醉剂均显示可诱导心肌收缩力和心脏负荷条件的剂量依赖性降低。这些抑制作用降低了心肌需氧量，因此可能对心肌缺血期间的心肌氧平衡具有有益作用。最近，实验证据已经清楚地表明，除了这些间接的保护作用，挥发性麻醉剂也有直接的保护性能，对可逆和不可逆的缺血性心肌损伤。这些特性不仅与直接的预处理效应有关，而且与对再灌注损伤程度的影响有关。在临床麻醉期间实施这些特性可以为围手术期缺血性心功能障碍的治疗或预防或两者提供额外的工具。在临床实践中，这些作用应与改善心脏功能相关，最终导致冠心病患者的结局更好。挥发性麻醉剂的这些保护特性在临床实践中的潜在应用是正在进行的研究的主题。本文综述了目前对这一问题的认识。
All volatile anesthetics have been shown to induce a dose-dependent decrease in myocardial contractility and cardiac loading conditions. These depressant effects decrease myocardial oxygen demand and may, therefore, have a beneficial role on the myocardial oxygen balance during myocardial ischemia. Recently, experimental evidence has clearly demonstrated that in addition to these indirect protective effects, volatile anesthetic agents also have direct protective properties against reversible and irreversible ischemic myocardial damage. These properties have not only been related to a direct preconditioning effect but also to an effect on the extent of reperfusion injury. The implementation of these properties during clinical anesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. In the clinical practice, these effects should be associated with improved cardiac function, finally resulting in a better outcome in patients with coronary artery disease. The potential application of these protective properties of volatile anesthetic agents in clinical practice is the subject of ongoing research. This review summarizes the current knowledge on this subject.