Interaction between anesthetic conditioning and ischemic preconditioning on metabolic function after hepatic ischemia–reperfusion in rabbits

• Published in: Journal of anesthesia 2018-08, Vol.32 (4), p.599-607
• Main Authors: Yamada, Takashige, Nagata, Hiromasa, Kosugi, Shizuko, Suzuki, Takeshi, Morisaki, Hiroshi, Kotake, Yoshifumi
• Format: Article
• Language: English
• Subjects: Analysis; Anesthesia; Anesthesiology; Care and treatment; Complications and side effects; Critical Care Medicine; Emergency Medicine; Intensive; Ischemia; Medicine; Medicine & Public Health; Methods; Original Article; Pain Medicine; Reperfusion injury; Risk factors
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-018-2523-7

Background Both anesthetic-induced and ischemic preconditioning are protective against hepatic ischemia–reperfusion injury. However, the effects of these preventive methods on the metabolic function remain to be elucidated. We investigated the anesthetic conditioning and ischemic preconditioning on the metabolic function of the rabbit model of hepatic ischemia–reperfusion. Methods After approval by the institutional animal care and use committee, 36 Japanese White rabbits underwent partial hepatic ischemia for 90 min either under sevoflurane or propofol anesthesia. All the rabbits underwent 90 min of hepatic ischemia, and half of the rabbits in each group underwent additional 10-min ischemia and 10-min reperfusion before index ischemia. Hepatic microvascular blood flow was intermittently measured during reperfusion period, and galactose clearance, serum aminotransferase activities, and lactate concentrations were determined 180 min after reperfusion. Results Neither anesthetic conditioning with sevoflurane nor ischemic preconditioning altered hepatic microvascular blood flow during reperfusion and serum transaminase activities after reperfusion. However, galactose clearance of reperfused liver was significantly higher under sevoflurane anesthesia than propofol (0.016 ± 0.005/min vs. 0.011 ± 0.004/min). Statistically significant interaction between anesthetic choice and application of ischemic preconditioning suggests that the ischemic preconditioning is selectively protective under propofol anesthesia. Increase of blood lactate concentration was significantly suppressed under sevoflurane anesthesia compared to propofol (1.5 ± 0.8 vs. 3.9 ± 1.4 mmol/l) without any statistically significant interaction with the application of ischemic preconditioning. Conclusion Sevoflurane attenuated the decrease of galactose clearance and increase of the blood lactate after reperfusion compared to propofol. Application of ischemic preconditioning was significantly protective under propofol anesthesia.