Different Effects of Volatile and Nonvolatile Anesthetic Agents on Long-Term Survival in an Experimental Model of Hemorrhagic Shock.

Abstract

BACKGROUND:

We investigated whether the cardioprotective, volatile gas anesthetic agent, isoflurane, could improve survival and organ function from hemorrhagic shock in an experimental rat model, compared to standard nonvolatile anesthetic agent ketamine/xylazine.

METHODS:

Sprague Dawley rats (both genders) were randomized to receive either intraperitoneal ketamine/xylazine (K/X, 90 and 10 mg/kg; n = 12) or isoflurane (5% isoflurane induction and 2% maintenance in room air; n = 12) for anesthesia. Blood was withdrawn to maintain mean arterial blood pressure at 30 mm Hg for 1 hour, followed by 30 minutes of resuscitation with shed blood. Rats were allowed to recover and survive for 6 weeks.

RESULTS:

During the shock phase, the total withdrawn blood volume (expressed as % of estimated total blood volume) to maintain a level of hypotension of 30 mm Hg was significantly higher in the isoflurane group (51.0% ± 1.5%) than in the K/X group (45.3% ± 1.8%; P = .023). Recovery of blood pressure during the resuscitation phase was significantly improved in the isoflurane group compared to the K/X group. The survival rate at 6 weeks was 1 (8.3%) of 12 in rats receiving K/X and 10 (83.3%) of 12 in rats receiving isoflurane (P < .001). Histology performed at 6 weeks demonstrated brain infarction in the 1 surviving rat receiving K/X; no brain infarction occurred in the 10 surviving rats that received isoflurane. No infarction was detected in heart, lung, liver, or kidneys among the surviving rats.

CONCLUSIONS:

Isoflurane improved blood pressure response to resuscitation and resulted in significantly higher long-term survival rate.

• Authors: Wangde Dai, Jianru Shi, Juan Carreno, Robert A Kloner
• Journal: Journal of cardiovascular pharmacology and therapeutics (J Cardiovasc Pharmacol Ther) Vol. 25 Issue 4 Pg. 346-353 (07 2020) ISSN: 1940-4034 [Electronic] United States
• PMID: 32292050 (Publication Type: Comparative Study, Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Anesthetics, Dissociative
• Anesthetics, Inhalation
• Ketamine
• Isoflurane

Topics

• Anesthetics, Dissociative (pharmacology)
• Anesthetics, Inhalation (pharmacology)
• Animals
• Blood Pressure (drug effects)
• Brain (drug effects, pathology)
• Brain Infarction (etiology, pathology, prevention & control)
• Disease Models, Animal
• Female
• Isoflurane (pharmacology)
• Ketamine (pharmacology)
• Male
• Rats, Sprague-Dawley
• Resuscitation
• Shock, Hemorrhagic (complications, drug therapy, physiopathology)
• Time Factors