VOLATILE ANAESTHETICS ANDCARDIAC PROTECTION
Moataz Mostafa Omran;
Abstract
Volatile anesthetic agents are liquids at room temperature, but they can be easily evaporated for administration by inhalation. All of these agents share the property of being quite hydrophobic.
The ideal volatile anesthetic agent offers smooth and reliable induction and maintenance of general anesthesia with minimal effects on other organ systems.
The pharmacodynamic effects of inhaled anesthetics must be based on a dose, and this dose is the minimum alveolar concentration or MAC. MAC is the alveolar concentration of an anesthetic at one atmosphere that prevents movement in response to a surgical stimulus in 50% of patients.
The volatile anesthetics are clearly the most popular drug used to maintain anesthesia. They are easily administered via inhalation, they are readily titrated, they have a high safety ratio in terms of preventing recall, and the depth of anesthesia can be quickly adjusted in a predictable way while monitoring tissue levels via end-tidal concentrations.
Myocardial ischemia in the perioperative stages is a serious adverse event that can increase morbidity and mortality after cardiac and non-cardiac surgery. The use of particular anesthetics for the induction and maintenance of general anesthesia is one of the proposed approaches to protect against the adverse effects of ischemia. Recent data from experimental and clinical studies indicate that some anesthetics, such as volatile general anesthetics and morphine, have protective effects against ischemia-reperfusion injury that are independent of their hemodynamic effects.
The volatile anesthetics mimic ischemic preconditioning and trigger a similar cascade of intracellular events resulting in myocardial protection that lasts beyond the elimination of the anesthetic. The cardioprotective effects of a volatile anesthetic regimen were also observed subsequently in off-pump coronary surgery.
The ideal volatile anesthetic agent offers smooth and reliable induction and maintenance of general anesthesia with minimal effects on other organ systems.
The pharmacodynamic effects of inhaled anesthetics must be based on a dose, and this dose is the minimum alveolar concentration or MAC. MAC is the alveolar concentration of an anesthetic at one atmosphere that prevents movement in response to a surgical stimulus in 50% of patients.
The volatile anesthetics are clearly the most popular drug used to maintain anesthesia. They are easily administered via inhalation, they are readily titrated, they have a high safety ratio in terms of preventing recall, and the depth of anesthesia can be quickly adjusted in a predictable way while monitoring tissue levels via end-tidal concentrations.
Myocardial ischemia in the perioperative stages is a serious adverse event that can increase morbidity and mortality after cardiac and non-cardiac surgery. The use of particular anesthetics for the induction and maintenance of general anesthesia is one of the proposed approaches to protect against the adverse effects of ischemia. Recent data from experimental and clinical studies indicate that some anesthetics, such as volatile general anesthetics and morphine, have protective effects against ischemia-reperfusion injury that are independent of their hemodynamic effects.
The volatile anesthetics mimic ischemic preconditioning and trigger a similar cascade of intracellular events resulting in myocardial protection that lasts beyond the elimination of the anesthetic. The cardioprotective effects of a volatile anesthetic regimen were also observed subsequently in off-pump coronary surgery.
Other data
| Title | VOLATILE ANAESTHETICS ANDCARDIAC PROTECTION | Other Titles | عقـاقـيـــر التـخـديــر الطـــيارة وحماية عضلة القلب | Authors | Moataz Mostafa Omran | Issue Date | 2015 |
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