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Comparison of 5 Different Remifentanil Strategies Against Myocardial Ischemia-Reperfusion Injury

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Author(s)
Kook Jin ChunYong Hyun ParkJeong Su KimYoungho JangJune Hong KimJun KimMi Young Lee
Keimyung Author(s)
Lee, Mi Young
Department
Dept. of Preventive Medicine (예방의학)
Journal Title
Journal of Cardiothoracic and Vascular Anesthesia
Issued Date
2011
Volume
25
Issue
6
Keyword
cardiodynamicsmyocardial ischemiapreconditioningpostconditioningremifentanil
Abstract
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 < 0.01). There was no significant difference in the left ventricular–developed 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/dtmax after reperfusion between the R-Pre (42.0% ± 16.9%) and control groups (39.0% ± 15.4%, p > 0.05), whereas the dP/dtmax 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.
Keimyung Author(s)(Kor)
이미영
Publisher
School of Medicine
Citation
Kook Jin Chun et al. (2011). Comparison of 5 Different Remifentanil Strategies Against Myocardial Ischemia-Reperfusion Injury. Journal of Cardiothoracic and Vascular Anesthesia, 25(6), 926–930. doi: 10.1053/j.jvca.2011.02.019
Type
Article
ISSN
1053-0770
Source
https://www.sciencedirect.com/science/article/pii/S105307701100053X?via%3Dihub
DOI
10.1053/j.jvca.2011.02.019
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33964
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
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