アブストラクト(49巻1号:神奈川歯学)

神奈川歯学

Japanese

Title : 心筋虚血再灌流障害を抑制するセボフルランの至適濃度 - in vivoウサギモデルにおける検討 -
Subtitle : 原著
Authors : 白濱淳, 今泉うの, 板倉紹子, 古屋宗孝, 有坂博史, 吉田和市
Authors(kana) :
Organization : 神奈川歯科大学大学院麻酔科学講座
Journal : 神奈川歯学
Volume : 49
Number : 1
Page : 24-33
Year/Month : 2014 / 6
Article : 原著
Publisher : 神奈川歯科大学学会
Abstract : 「緒言」近年, 虚血性心疾患を伴う患者の全身麻酔症例や虚血再灌流を伴う手術の増加とともに虚血再灌流障害に関する研究が数多く報告されている. 虚血再灌流障害とは虚血状態に置かれた心筋組織が急激な再酸素化に伴い, 組織障害がさらに促進する現象である. 臨床的には心停止後に血流が再開された場合, 異型狭心症でスパズムが解除された場合, PCI(経皮的冠動脈インターベンション), CABG(冠動脈バイパス手術)で血流が再開された場合などに起こる. その機序としてはATP代謝の破綻, Ca2+の過負荷, 活性酸素などの関与が報告されている. 心筋虚血再灌流障害に対する心筋保護に関しては, 本格的な虚血前の短時間の頻回虚血, セボフルランなどの吸入麻酔薬や薬剤によるプレコンディショニングおよびポストコンディショニングが報告されている. また, セボフルラン, イソフルランなどの揮発性吸入麻酔薬そのものが心筋に保護的に作用することが明らかになっている.
Practice : 歯科学
Keywords : セボフルラン, 虚血再灌流障害, 心筋保護

English

Title : Optimal Sevoflurane Concentration for Attenuating Myocardial Ischemia / reperfusion Injury - A Study in in vivo Rabbit Model -
Subtitle :
Authors : Jun SHIRAHAMA, Uno IMAIZUMI, Shoko ITAKURA, Munetaka FURUYA, Hirofumi ARISAKA, Kazu-ichi YOSHIDA
Authors(kana) :
Organization : Department of Anesthesiology, Kanagawa Dental University, School of Dentistry
Journal : Kanagawa Shigaku
Volume : 49
Number : 1
Page : 24-33
Year/Month : 2014 / 6
Article : Original article
Publisher : Kanagawa Odontological Society
Abstract : [Abstract] This study was designed to investigate the cardioprotective effects of different concentrations of sevoflurane exposure on myocardial ischemia / reperfusion injury in in vivo rabbit hearts. Rabbits were subjected to regional ischemia by 30 min of the left anterior descending artery (LAD) occlusion followed by 180 min of reperfusion under general anesthesia with ketamine and xylazine infusion. The animals were randomly assigned to the following 5 treatment groups : a control group, a continuous infusion of 0.5% sevoflurane group, a 1.0% sevoflurane group, a 1.5% sevoflurane group and a 2.0% sevoflurane group. Sevoflurane infusion group animals received continuous exposure of sevoflurane from 5 minutes prior to ischemia up to the end of reperfusion. At the end of the 180 min reperfusion period, risk area and infarct size were measured. Heart Rate, mean arterial blood pressure, and rate pressure product revealed no significant difference among all the groups tested. The risk area showed no significant differences among all the groups. Mean infarct size of the risk area was significantly less in 1.0% sevoflurane group and 1.5% sevoflurane group than a control group. The incidence and duration of arrhythmias during myocardial ischemia was no significant difference among all the groups. The incidence of arrhythmias during reperfusion was significantly less in 1.5% and 2.0% sevoflurane group than a control group. The duration of arrhythmias during reperfusion was significantly less in all the sevoflurane treatment groups compared with a control group. These results suggest that 1.0% and 1.5% sevoflurane given before coronary artery occlusion has an infarct size limiting effect in the myocardium, and 1.5% and 2.0% sevoflurane has an antiarrhythmic effect during reperfusion in the rabbit heart. It was suggested that the optimal concentration of sevoflurane to elicit the most potent cardioprotection is 1.5% in in vivo rabbit model.
Practice : Dentistry
Keywords :