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Isoflurane and coronary heart disease
Author(s) -
Agnew N. M.,
Pennefather S. H.,
Russell G. N.
Publication year - 2002
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2002.02469.x
Subject(s) - medicine , isoflurane , cardiology , perfusion , coronary steal , myocardial ischaemia , ischemia , limiting , coronary artery disease , adenosine , anesthesia , coronary heart disease , myocardial ischemia , mechanical engineering , engineering
Summary Early studies indicated that isoflurane caused coronary steal and should therefore be avoided in patients with coronary heart disease. Subsequently, more detailed trials have disputed this and ␣␣have shown that as long as coronary perfusion pressure is maintained, isoflurane does not cause coronary steal or myocardial ischaemia. There is now growing evidence, initially in animal work but more recently in human studies, that isoflurane has myocardial protective properties, limiting infarct size and improving functional recovery from myocardial ischaemia. The mechanism for ␣␣this protection mimics ischaemic preconditioning and involves the opening of adenosine triphosphate‐dependent potassium channels. The few studies comparing the myocardial protection offered by individual anaesthetic agents indicate that isoflurane represents the anaesthetic agent of choice for patients with coronary heart disease.