Effects of sevoflurane and propofol on ischaemia–reperfusion injury after thoracic-aortic occlusion in pigs

Background. Thoraco-abdominal-aneurysm surgery predicts high mortality. Propofol and sevoflurane are commonly used anaesthetics for this procedure. Halogenated anaesthetics induce organ protection similar to ischaemic preconditioning. We investigated which anaes-thetic regimen would lead to a better protection against ischaemia–reperfusion injury induced by temporary thoracic-aortic occlusion. Methods. Following initial fentanyl–midazolam anaesthesia for surgical preparation, 18 pigs were randomly assigned to two groups: group one received propofol (n9) and group two sevoflurane (n9) before, during, and after lower body ischaemia in an investigator blinded fashion. Ten animals without aortic occlusion served as time controls (propofol, n5; sevoflur-ane, n5). For induction of ischaemia, the thoracic aorta was occluded by a balloon-catheter for 90 min. After 120 min of reperfusion, the study anaesthetics were discontinued and fenta-nyl–midazolam re-established for an additional 180 min. Goal-directed therapy was performed during reperfusion. Fluid and catecholamine requirements were assessed. Serum samples and intestinal tissue specimens were obtained. Results. Severe declamping shock occurred in both study groups. While norepinephrin