Skip to main content

Volume 10 Supplement 1

de Senectute: Age and Health Forum

  • Lecture presentation
  • Open access
  • Published:

Up to date in inhalation anaesthesia: the desflurane

Background

The use of halogenated anaesthetics in cardiac surgery is still controversial. Preconditioning and postconditioning are the well described mechanisms that explain the protective myocardial effect of specific drugs in order to prevent the occurrence and/or to reduce the size of a necrotic post-ischemic myocardial area [1]: they play a well recognized role in the “protective effect” of the halogenated anaesthetics. Preconditioning and postconditioning protect the myocardial cell from oxidative stress and take place through the activation of specific receptors and second messengers systems [2]. Desflurane has shown a higher preconditioning and postconditioning power that could be optimal at 6% of Minimum Alveolar Concentration (MAC) [3]. The solubility of the halogenated anaesthetics can be altered during cardiac surgery: Desflurane has shown a rapid wash-in and wash-out profile in cardiac “on pump” surgery [5, 6].

Conclusions

Halogenated anaesthetics and especially desflurane protect myocardium from the peri-operative ischemic injury even in case of high risk elderly patients [7].

References

  1. Murry CE, Jennings NB, Reimer KA: Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986, 74: 1124-1136.

    Article  PubMed  CAS  Google Scholar 

  2. Baines CP, Zhang J, Wang G-W, Zheng YT, Xiu JX, Cardwell EM, Bolli R, Ping P: Mitochondrial PKC ε and MAPK from signaling modules in the murine heart. Circ Res. 2002, 90: 390-97. 10.1161/01.RES.0000012702.90501.8D.

    Article  PubMed  CAS  Google Scholar 

  3. Guarracino F, Landoni G, Tritapepe L, Pompei F, Leoni A, Aletti G, Scandroglio AM, Maselli D, De Luca M, Marchetti C, Crescenzi G, Zangrillo A: Myocardial damage prevented by volatile anesthetics: a multicenter randomized controlled study. J Cardiothorac Vasc Anaesth. 2006, 20 (4): 477-83. 10.1053/j.jvca.2006.05.012.

    Article  CAS  Google Scholar 

  4. Zhou J, Lu J: Dynamic changes in blood Solubility of desflurane, isoflurane, and halothane during cardiac surgery. J Cardiothorac Vasc Anaesth. 2001, 15 (5): 555-9. 10.1053/jcan.2001.26529.

    Article  CAS  Google Scholar 

  5. Mets B, Reich NT, Mellas N, Beck J, Park S: Desflurane pharmacokinetics during cardiopulmonary bypass. J Cardiothorac Vasc Anaesth. 2001, 15 (2): 179-82. 10.1053/jcan.2001.21945.

    Article  CAS  Google Scholar 

  6. De Hert SG, Cromheecke S, ten Broecke PW, Mertens E, De Blier IG, Stockman BA, Rodrigus IE, Van der Linden PJ: Effects of propofol, desflurane, and sevoflurane on recovery of myocardial function after coronary surgery in elderly high-risk patients. Anesthesiology. 2004, 99 (2): 314-23. 10.1097/00000542-200308000-00013.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Caroleo, S., Bruno, O., Vuoto, D. et al. Up to date in inhalation anaesthesia: the desflurane. BMC Geriatr 10 (Suppl 1), L56 (2010). https://doi.org/10.1186/1471-2318-10-S1-L56

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/1471-2318-10-S1-L56

Keywords