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Li F, Sugishita K, Su Z, Ueda I, Barry WH. Activation of connexin-43 hemichannels can elevate [Ca(2+)]i and [Na(+)]i in rabbit ventricular myocytes during metabolic inhibition. J Mol Cell Cardiol 2001; 33:2145-55. [PMID: 11735261 DOI: 10.1006/jmcc.2001.1477] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ATP depletion due to ischemia or metabolic inhibition (MI) causes Na(+) and Ca(2+) accumulation in myocytes, which may be in part due to opening of connexin-43 hemichannels. Halothane (H) has been shown to reduce conductance of connexin-43 hemichannels and to protect the heart against ischemic injury. We therefore investigated the effect of halothane on [Ca(2+)]i and [Na(+)]i in myocytes during MI. Isolated rabbit left ventricular myocytes were loaded with 4 microM fluo-3 AM for 30 min, or with 5 microM sodium green AM for 60 min at 37 degrees C. After washing, the myocytes were exposed to: (1) Normal HEPES solution; (2) MI solution (2 mM NaCN, 20 mM 2-deoxy-D-glucose and 0-glucose); or (3) MI+H (0.95 mM, 4.7 mM) for 60 min. Propidium iodide (PI, 25 microM) was added to all samples before data acquisition. The fluorescence intensity was measured by flow cytometry with 488 nm excitation and 530 nm emission for fluo-3 or sodium green, and 670 nm for PI. The [Ca(2+)]i and [Na(+)]i were then calculated by calibration. In some experiments, the effect of 10 microM tetrodotoxin (TTX) and 20 microM nifedipine (NIF) were studied. Metabolic inhibition for 60 min caused a significant increase in [Ca(2+)]i and [Na(+)]i in myocytes when compared to controls, which was significantly reduced by halothane in a dose-dependent fashion. In the presence of TTX and NIF, halothane also significantly reduced the rise in the [Ca(2+)]i and [Na(+)]i in myocytes subjected to MI. 1-heptanol, another gap junction blocker, had similar effects. Thus, halothane reduced [Ca(2+)]i and [Na(+)]i overload produced by MI in myocytes. This effect is not solely due to block of voltage-gated Na(+) and Ca(2+) channels, and is likely mediated by inhibiting the opening of connexin-43 hemichannels.
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Affiliation(s)
- F Li
- Cardiology Division, University of Utah School of Medicine, 50 N Medical Drive, Salt Lake City, Utah 84132, USA
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Coetzee JF, le Roux PJ, Genade S, Lochner A. Reduction of postischemic contractile dysfunction of the isolated rat heart by sevoflurane: comparison with halothane. Anesth Analg 2000; 90:1089-97. [PMID: 10781458 DOI: 10.1097/00000539-200005000-00016] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Our aims were to evaluate the effect of sevoflurane on postcardioplegic functional recovery of the isolated rat heart including the role of the adenosine triphosphate regulated potassium (K(ATP)) channels and to compare the cardioprotective effects of equipotent concentrations of halothane and sevoflurane. Isolated perfused rat hearts were subjected to 45 or 60 min normothermic cardioplegic arrest and 30 min reperfusion. Sevoflurane (0.9% and 1. 7%), halothane (0.4% and 0.8%), or sevoflurane (0.9%) plus glibenclamide (10 microM) (a K(ATP) channel blocker) were administered at different time intervals. Measurements of mechanical activity were made before and after arrest. Function during reperfusion after cardioplegic arrest was significantly depressed in both untreated and treated hearts. However, sevoflurane administered both before and after arrest, or before only, significantly improved functional recovery after 45 min of cardioplegia. This protective effect was abolished by simultaneous administration of glibenclamide, suggesting a role of the K(ATP) channel. Sevoflurane was as effective as halothane in improving postcardioplegic functional performance. After 45 min of arrest, hearts exposed to either anesthetic at both concentrations had a significantly higher work performance on discontinuation of their administration than untreated controls. After 60 min of arrest, neither anesthetic elicited protection.
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Affiliation(s)
- J F Coetzee
- Department of Anesthesiology, University of Stellenbosch Faculty of Medicine, Tygerberg, Republic of South Africa
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Nakamura T, Kashimoto S, Oguchi T, Kumazawa T. Hydroxyl radical formation during inhalation anesthesia in the reperfused working rat heart. Can J Anaesth 1999; 46:470-5. [PMID: 10349928 DOI: 10.1007/bf03012948] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine whether isoflurane, sevoflurane and halothane influenced hydroxyl radical production in the ischemic rat heart. METHODS Twenty-four male Wistar rats were divided into four groups; control (C), isoflurane 1.4% (I), sevoflurane 2.5% (S) and halothane 1% (H). The hearts were perfused with modified Krebs-Henseleit bicarbonate buffer by a working heart model for 10 min. Then, whole heart ischemia was induced by severely restricting coronary perfusion for 15 min. Reperfusion of the hearts after this ischemic period lasted for 20 min. The coronary effluent was collected before and during ischemia and at 1, 5, 10, 20 min after reperfusion. At the end of reperfusion, hearts were removed and prepared for measurement. Hydroxyl radicals were identified by their reaction with salicylic acid to yield dihydroxybenzoic acids (DHBAs). RESULTS Before and after ischemia, there were no differences in coronary flow and heart rate among the four groups, but cardiac output and LV dP/dt maximum in the anesthetic groups were lower than in the control group. Hydroxyl radical products in the heart were significantly lower in the I group than the other groups (e.g. C vs I, 278.1 +/- 24.3 vs 219.3 +/- 14.4 microM x g(-1), P < 0.05). The concentrations of DHBAs in the coronary effluent at some points in the I and H groups were less than in the C and S groups. CONCLUSION These results indicate that isoflurane and halothane (to a lesser extent), reduce hydroxyl radical production in the ischemic heart, but sevoflurane does not.
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Affiliation(s)
- T Nakamura
- Department of Anesthesiology, Yamanashi Medical University, Nakakoma-gun, Japan
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Conradie S, Coetzee A, Coetzee J. Anesthetic modulation of myocardial ischemia and reperfusion injury in pigs: comparison between halothane and sevoflurane. Can J Anaesth 1999; 46:71-81. [PMID: 10078408 DOI: 10.1007/bf03012519] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Halothane offers protection against the reperfusion injury of the myocardium. This study compared sevoflurane with halothane in its potential to modulate the effects of acute severe ischemia and reperfusion on the myocardium. METHODS Experiments were conducted on 25 pigs. Anesthesia consisted of thiopental, vecuronium and fentanyl. The lungs were mechanically ventilated with oxygen and nitrogen. Animals were randomly allocated to receive either I MAC halothane or sevoflurane. A control group received fentanyl and pentobarbital. Regional myocardial function was measured with sonomicrometers. The left anterior descending coronary artery was occluded for 15 min followed by 60 min reperfusion. RESULTS Neither halothane nor sevoflurane protected the heart against the effects of acute and severe regional myocardial ischemia. During reperfusion, 89% of the animals receiving sevoflurane suffered from ventricular fibrillation compared with 30% in the halothane group (P < 0.005). Five minutes into the reperfusion period the animals subjected to halothane anesthesia demonstrated an 88% recovery in regional myocardial systolic function while in the sevoflurane group the recovery was 40% of pre-ischemic control (P < 0.05). CONCLUSION Halothane is associated with less reperfusion arrhythmias and, in addition, recovery of regional myocardial function during reperfusion was more rapid in the presence of halothane than with sevoflurane.
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Affiliation(s)
- S Conradie
- Department of Anesthesiology, University of Stellenbosch Medical School, Tygerberg, South Africa
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Preckel B, Schlack W, Thamer V. Enflurane and Isoflurane, but Not Halothane, Protect Against Myocardial Reperfusion Injury after Cardioplegic Arrest with HTK Solution in the Isolated Rat Heart. Anesth Analg 1998. [DOI: 10.1213/00000539-199812000-00001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Preckel B, Schlack W, Thämer V. Enflurane and isoflurane, but not halothane, protect against myocardial reperfusion injury after cardioplegic arrest with HTK solution in the isolated rat heart. Anesth Analg 1998; 87:1221-7. [PMID: 9842801 DOI: 10.1097/00000539-199812000-00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED To investigate the effects of halothane, enflurane, and isoflurane on myocardial reperfusion injury after ischemic protection by cardioplegic arrest, isolated perfused rat hearts were arrested by infusion of cold HTK cardioplegic solution containing 0.015 mmol/L Ca2+ and underwent 30 min of ischemia and a subsequent 60 min of reperfusion. Left ventricular (LV) developed pressure and creatine kinase (CK) release were measured as variables of myocardial function and cellular injury, respectively. In the treatment groups (each n = 9), anesthetics were given during the first 30 min of reperfusion in a concentration equivalent to 1.5 minimum alveolar anesthetic concentration of the rat. Nine hearts underwent the protocol without anesthetics (controls). Seven hearts underwent ischemia and reperfusion without cardioplegia and anesthetics. In a second series of experiments, halothane was tested after cardioplegic arrest with a modified HTK solution containing 0.15 mmol/L Ca2+ to investigate the influence of calcium content on protective actions against reperfusion injury by halothane. LV developed pressure recovered to 59%+/-5% of baseline in controls. In the experiments with HTK solution, isoflurane and enflurane further improved functional recovery to 84% of baseline (P < 0.05), whereas halothane-treated hearts showed a functional recovery similar to that of controls. CK release was significantly reduced during early reperfusion by isoflurane and enflurane, but not by halothane. After cardioplegic arrest with the Ca2+-adjusted HTK solution, halothane significantly reduced CK release but did not further improve myocardial function. Isoflurane and enflurane given during the early reperfusion period after ischemic protection by cardioplegia offer additional protection against myocardial reperfusion injury. The protective actions of halothane depended on the calcium content of the cardioplegic solution. IMPLICATIONS Enflurane and isoflurane administered in concentrations equivalent to 1.5 minimum alveolar anesthetic concentration in rats during early reperfusion offer additional protection against myocardial reperfusion injury even after prior cardioplegic protection. Protective effects of halothane solely against cellular injury were observed only when cardioplegia contained a higher calcium concentration.
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Affiliation(s)
- B Preckel
- Institut für Klinische Anaesthesiologie, Heinrich-Heine-Universität, Düsseldorf, Germany.
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Honda O, Inoue K, Takaba T. [Protective effects of halothane on ischemic reperfusion injury on rat perfused hearts]. THE JAPANESE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY : OFFICIAL PUBLICATION OF THE JAPANESE ASSOCIATION FOR THORACIC SURGERY = NIHON KYOBU GEKA GAKKAI ZASSHI 1998; 46:1292-6. [PMID: 10037838 DOI: 10.1007/bf03217918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
UNLABELLED We evaluated the possible cardioprotective effects of halothane in isolated rat hearts. Langendorff perfusion was initiated by using Krebs-Henseleit Buffer (KHB) heated at 37 degrees C. CONTROL GROUP After 15 mins Langendorff perfusion, global ischemia was induced for 40 mins at 37 degrees C by clamping aorta, followed by 60 mins of reperfusion. Experimental group: Global ischemia was induced at the same time course as the control group and during reperfusion, halothane administered at the concentration of 1%, 2%, 3%. Cardiac function (heart rate, coronary flow, Vmax of the left ventricule) and intracelluar calcium level was measured during pre-ischemia, ischemia and reperfusion period. Recovery of cardiac function after ischemia was better in the 1% halothane group than in the control group but suppression on cardiac function inclined to increase concentration dependently. Compared to the control group, increase of intracellular calcium level after ischemia was suppressed in the halothane administered group at all concentration level. These data suggests that a low dose halothane administration shows a cardioprotective effects during reperfusion.
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Affiliation(s)
- O Honda
- First Department of Surgery, University of Showa, Tokyo, Japan
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Effects of sevoflurane and isoflurane on free radical formation in the post-ischaemic reperfused heart. Eur J Anaesthesiol 1998. [DOI: 10.1097/00003643-199809000-00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- B A Finegan
- Department of Anaesthesia, University of Alberta, Edmonton, Canada.
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Coetzee A, Roussouw G, Macgregor L. Failure of allopurinol to improve left ventricular stroke work after cardiopulmonary bypass surgery. J Cardiothorac Vasc Anesth 1996; 10:627-33. [PMID: 8841871 DOI: 10.1016/s1053-0770(96)80141-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study examined the effects of allopurinol on global left ventricular function after coronary artery bypass surgery. DESIGN A randomized prospective partially blinded study in 52 patients undergoing elective coronary artery bypass surgery. SETTING Conducted in a university-affiliated tertiary care facility. INTERVENTIONS Participants received 400 mg of allopurinol 18 hours and 400 mg of allopurinol orally 3 hours before surgery or no allopurinol. Patients then received a standard anesthetic technique consisting of target-controlled opiate infusion and inhalation anesthesia. Coronary artery bypass was performed using moderate hypothermia and oxygenated crystalloid cardioplegia. MEASUREMENTS AND MAIN RESULTS Global left ventricular function was assessed by means of left ventricular stroke work index (LVSWI) calculated before and after induction of anesthesia and after cardiopulmonary bypass at 15 minutes, 6, 12 and 24 hours. There was no difference in the LVSWI before or after surgery when the two groups were compared. CONCLUSIONS In this population sample, the use of preoperative allopurinol did not result in improved left ventricular stroke work after coronary artery bypass surgery.
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Affiliation(s)
- A Coetzee
- Department of Anesthesiology, University of Stellenbosch Medical School, Tygerberg, South Africa
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Kersten JR, Lowe D, Hettrick DA, Pagel PS, Gross GJ, Warltier DC. Glyburide, a KATP Channel Antagonist, Attenuates the Cardioprotective Effects of Isoflurane in Stunned Myocardium. Anesth Analg 1996. [DOI: 10.1213/00000539-199607000-00006] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kersten JR, Lowe D, Hettrick DA, Pagel PS, Gross GJ, Warltier DC. Glyburide, a KATP channel antagonist, attenuates the cardioprotective effects of isoflurane in stunned myocardium. Anesth Analg 1996; 83:27-33. [PMID: 8659760 DOI: 10.1097/00000539-199607000-00006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This investigation examined the role of myocardial adenosine triphosphate-regulated potassium (KATP) channels in isoflurane-induced enhancement of myocardial function after reversible tissue injury produced by a 15-min left anterior descending coronary artery occlusion (LAD) and reperfusion. Dogs (n = 14) were chronically instrumented for measurement of left ventricular (LV) and aortic blood pressure, cardiac output, coronary blood flow velocity, and subendocardial segment length. Regional myocardial contractility was evaluated with preload recruitable work area (PRWA). Isovolumic relaxation was assessed with a time constant (tau). Hemodynamic variables and LV function were measured in the conscious state, during 2% isoflurane anesthesia for 45 min before and during a 15-min LAD occlusion, and at several intervals after reperfusion in dogs pretreated with glyburide (0.3 mg/kg, intravenously) or drug vehicle. LAD occlusion caused regional dyskinesia and increases in tau. Vehicle-pretreated dogs demonstrated full recovery of segment shortening by 5 h postreperfusion and recovery of PRWA and tau by 30 min postreperfusion. In contrast, dogs pretreated with glyburide demonstrated sustained systolic and diastolic dysfunction. Segment shortening recovered to only 70% +/- 5%, PRWA remained depressed at 48% +/- 10% and tau was prolonged to 116% +/- 5% of control values at 5 h postreperfusion. The results indicate that isoflurane enhances recovery of myocardial contractile function by 5 h postreperfusion, in comparison to previous findings in conscious dogs. These effects are partially blocked by glyburide pretreatment, indicating that KATP channel activation by isoflurance may mediate these cardioprotective effects.
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Affiliation(s)
- J R Kersten
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA
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Sahlman L, Waagstein L, Haljamäe H, Ricksten SE. Protective effects of halothane but not isoflurane against global ischaemic injury in the isolated working rat heart. Acta Anaesthesiol Scand 1995; 39:312-6. [PMID: 7793207 DOI: 10.1111/j.1399-6576.1995.tb04068.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The effects of equi-anaesthetic concentrations of halothane (HAL) and isoflurane (ISO) on myocardial performance, perfusion, oxygenation and lactate release were studied before, during and after a low-flow, global ischaemic insult in isolated, paced rat left heart preparations. An antegrade perfusion technique was used, where left atrial pressure (LAP) and mean aortic pressure (MAP) could be altered independently of each other. Aortic flow, coronary flow (CF) and PO2 in venous coronary effluent were continuously recorded and stroke volume, myocardial oxygen consumption (MVO2) and myocardial oxygen extraction as well as lactate release were calculated. The hearts were exposed for at least ten minutes to the perfusate without (control, n = 10) or with HAL (n = 10) or ISO (n = 10) at a MAP of 80 mmHg (10.4 kPa) and a LAP of 7.5 mmHg (1.0 kPa). After baseline measurements, MAP was reduced to 25 mmHg (3,2 kPa) for a total of nine minutes. Thereafter MAP was increased to 80 mmHg (10.4 kPa) for another nine minute period. During the whole experimental procedure, LAP was maintained at 7.5 mmHg (1.0 kPa) and heart rate at 325 beats per minute. In the pre-ischaemic control period, MVO2 was lower with HAL compared to ISO (P < 0.05) and control (P < 0.05). Stroke volume was also lower with HAL compared to control (P < 0.05). During hypoperfusion, lactate release was twice as high in the control group (P < 0.01) and with ISO (P < 0.01) compared to HAL.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- L Sahlman
- Department of Anaesthesia and Intensive Care, Sahlgren's Hospital, University of Gothenburg, Sweden
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Louvier N, Lançon JP. [Do halogenated anesthetics protect from ischemic and reperfusion myocardial injuries?]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1994; 13:690-8. [PMID: 7733519 DOI: 10.1016/s0750-7658(05)80726-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Ischaemia and reperfusion of the myocardium are associated with cellular injuries leading to a decrease of contractile function and the occurrence of arrhythmias. As reperfusion of an ischaemic heart results in an intracellular overload of calcium, a calcium blocking agent pretreatment has been shown to exert a protective effect. By altering myocardial calcium fluxes, volatile anesthetics might also protect the myocardium from ischaemic damage and reperfusion injuries. A beneficial effect of volatile anesthetics on the ischaemic myocardium has been shown in numerous studies. These agents decrease the severity of ischaemia as well as the incidence of reperfusion arrhythmias and improve recovery of myocardial mechanics during reperfusion. They also preserve myocardial energetics and protect from oxygen-derived free radicals injury. However, some studies do not support these protective effects. The wide discrepancy between the various protocols might explain the discrepancy of the results. Enflurane and halothane seem to be more efficient than isoflurane. This cannot only be explained by different cardiovascular effects, but also by a specific effect on myocardial cells. Halothane and enflurane mainly decrease intracellular calcium availability by a direct effect on sarcoplasmic reticulum, while isoflurane only decreases the transsarcolemnal calcium entry. Enflurane and halothane have more beneficial effects than isoflurane on free radicals induced myocardial injuries. In conclusion, despite a wide diversity between the different studies, halothane and enflurane have better protective properties against ischaemia and reperfusion myocardial injuries than isoflurane.
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Affiliation(s)
- N Louvier
- Département d'Anesthésie-Réanimation, Hôpital du Bocage, Dijon
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