Sevoflurane reduces dysrhythmias during reperfusion in the working rat heart.

Purpose: The effects of sevoflurane on myocardial reperfusion injury have not been well studied. The purpose of this study was to determine the effects of sevoflurane on myocardial function, arrhythmia, and metabolism during reperfusion in an isolated working rat heart model.

Methods: Thirty-two hearts were divided into four groups according to the timing of 2.5% sevoflurane administration: group I, control, no sevoflurane; group II, sevoflurane administered only before ischemia; group III, sevoflurane only during reperfusion; group IV, sevoflurane during the whole study period. Myocardial contractility, myocardial ATP, lactate, and glycogen levels were assessed in the reperfusion period following global heart ischemia of 15 min duration. The incidence and duration of ventricular fibrillation were also observed in the reperfusion period.

Results: There was no difference in cardiac output and left ventricular dP/ dt max among the four groups at 10, 15, and 20 min after reperfusion. There was no difference in myocardial ATP, lactate and glycogen contents between the groups. The incidences of ventricular fibrillation during reperfusion were 100%, 63%, 100%, and 25% (P < 0.05 vs control), and the durations of ventricular fibrillation during reperfusion were 375 +/- 269, 104 +/- 98 (P < 0.05 vs control), 303 +/- 189, and 93 +/- 245 (P < 0.05 vs control) in groups I, II, III, and IV, respectively (mean +/- SD).

Conclusion: The administration of sevoflurane prior to reperfusion appears to provide myocardial protection, as assessed by reduced dysrhythmias during reperfusion.