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首页> 外文期刊>Journal of cardiothoracic and vascular anesthesia >Comparison of 5 different remifentanil strategies against myocardial ischemia-reperfusion injury
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Comparison of 5 different remifentanil strategies against myocardial ischemia-reperfusion injury

机译：5种瑞芬太尼抗心肌缺血再灌注损伤策略的比较

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Objective: The purpose of this study was to investigate the effects of various remifentanil strategies (preconditioning, postconditioning, or continuous infusion) against myocardial ischemia-reperfusion injury. Design: An in vitro experimental study using the Langendorff system. Setting: A university research laboratory. Participants: Male Sprague-Dawley rats (each n = 9). Interventions: Five different remifentanil strategies were performed in isolated rat hearts as follows: remifentanil preconditioning (R-Pre), remifentanil postconditioning (R-Post), ischemic targeting remifentanil (R1), reperfusion targeting remifentanil (R2), or both ischemic and reperfusion targeting remifentanil (R3). Infarct size and cardiodynamics were compared. Measurement and Main Results: The infarct-risk volume ratio in groups R-Pre (13.7% ± 9.9%), R-Post (13.7% ± 12.3%), and R3 (12.6% ± 6.1%) were decreased significantly compared with the untreated control hearts (32.9% ± 11.1%, p &lt 0.01). There was no significant difference in the left ventriculardeveloped pressure (LVDP) recovery after reperfusion between the control (43.6% ± 14.5%) and R-Pre (34.8% ± 12.9%, p 0.05) groups after reperfusion. However, the LVDP recovery in R-Post (21.6% ± 7.7%, p 0.05), R1 (16.7% ± 19.8%, p 0.01), R2 (22.2% ± 13.9%, p 0.05), and R3 (16.2% ± 7.8%, p 0.01) was decreased significantly compared with control hearts. There was no significant difference in the recovery of dP/dt max after reperfusion between the R-Pre (42.0% ± 16.9%) and control groups (39.0% ± 15.4%, p 0.05), whereas the dP/dt max in R3 group (16.9% ± 9.0%) was decreased significantly compared with R-Pre (p 0.05). Conclusions: Preconditioning or postconditioning by remifentanil and the continuous infusion of remifentanil effectively reduce myocardial infarction, whereas reperfusion targeting ischemic targeting or reperfusion targeting remifentanil does not. Remifentanil preconditioning better preserves myocardial function, especially LVDP, than other remifentanil strategies.
机译：目的：本研究的目的是研究瑞芬太尼各种策略（预处理，后处理或持续输注）对心肌缺血-再灌注损伤的影响。设计：使用Langendorff系统进行的体外实验研究。地点：大学研究实验室。参与者：雄性Sprague-Dawley大鼠（每只n = 9）。干预措施：在离体大鼠心脏中进行了五种不同的瑞芬太尼策略，分别是：瑞芬太尼预处理（R-Pre），瑞芬太尼后处理（R-Post），缺血靶向瑞芬太尼（R1），缺血再灌注瑞芬太尼（R2）或缺血和再灌注靶向瑞芬太尼（R3）。比较梗死面积和心脏动力学。测量和主要结果：与对照组相比，R-Pre组（13.7％±9.9％），R-Post组（13.7％±12.3％）和R3组（12.6％±6.1％）的梗塞风险体积比显着降低。未经治疗的对照心脏（32.9％±11.1％，p <0.01）。再灌注后对照组（43.6％±14.5％）和R-Pre（34.8％±12.9％，p> 0.05）组之间的再灌注后左心室发育压力（LVDP）恢复无显着差异。但是，R-Post（21.6％±7.7％，p <0.05），R1（16.7％±19.8％，p <0.01），R2（22.2％±13.9％，p <0.05）和R3（与对照组相比，有16.2％±7.8％，p <0.01）显着降低。 R-Pre（42.0％±16.9％）与对照组（39.0％±15.4％，p> 0.05）之间的再灌注后dP / dt max的恢复无显着差异，而R3中的dP / dt max与R-Pre组相比，组（16.9％±9.0％）显着下降（p <0.05）。结论：瑞芬太尼进行预处理或后处理以及瑞芬太尼的连续输注可有效减少心肌梗塞，而缺血再灌注或瑞芬太尼的再灌注则不能。瑞芬太尼预处理比其他瑞芬太尼策略更好地保留了心肌功能，尤其是LVDP。

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