Protective effect of sevoflurane on hepatic ischaemia/reperfusion injury in the rat A dose-response study

BACKGROUNDIschaemia/reperfusion injury is a common problem in hepatic surgery. An appreciation of the role of sevoflurane dose in preconditioning and subsequent hepatoprotection against ischaemia/reperfusion injury would be useful.OBJECTIVEThe aim of current study was to investigate the protective effect of sevoflurane preconditioning at different doses on hepatic ischaemia/reperfusion injury in rats.DESIGNRandomised, controlled, laboratory study.SETTINGThe Department of Anaesthesiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, China.PARTICIPANTSFifty male Sprague-Dawley rats weighing 200 to 250g, randomly assigned to five groups.INTERVENTIONSControl group (sham surgery, no ischaemia/reperfusion), I/R group (ischaemia/reperfusion but no sevoflurane pretreatment), S1 [1 minimum alveolar concentration (MAC)=2.4%], S2 (1.5 MAC=3.6%) and S3 (2 MAC=4.8%) groups with sevoflurane pretreatment, respectively, followed by 60min ischaemia and 120min reperfusion.MAIN OUTCOME MEASURESAt the end of reperfusion, serum levels of alanine aminotransferase and aspartate aminotransferase as well as superoxide dismutase activity, myeloperoxidase and malondialdehyde content in the liver were determined. Histological examination of the liver was also performed.RESULTSSerum levels of aspartate aminotransferase and alanine aminotransferase in the sevoflurane groups were significantly reduced compared to the elevated levels seen in the I/R group (P<0.05). In the liver, the I/R-induced increase in myeloperoxidase activity and malondialdehyde level were significantly reduced by all sevoflurane concentrations (P<0.05). The decrease in superoxide dismutase activity induced by I/R was prevented by all sevoflurane pretreatments (P<0.05). No significant differences between the S1, S2 and S3 groups were seen in any of the above variables.CONCLUSIONSevoflurane pretreatment exerts a protective effect on hepatic ischaemia/reperfusion injury but there is no significant dose-response relationship in the concentration range used. It is possible that a dose-response relationship might exist at lower concentrations.