Sevoflurane Preconditioning plus Postconditioning Decreases Inflammatory Response with Hemodynamic Recovery in Experimental Liver Ischemia Reperfusion

Abstract

Objective. The inhalation anesthetic sevoflurane has presented numerous biological activities, including anti-inflammatory properties and protective effects against tissue ischemic injury. This study investigated the metabolic, hemodynamic, and inflammatory effects of sevoflurane pre- and postconditioning for short periods in the rescue of liver ischemia-reperfusion (IR) injury using a rat model. Materials and Methods. Twenty Wistar rats were divided into four groups: sham group, control ischemia group (partial warm liver ischemia for 45min followed by 4h of reperfusion), SPC group (administration of sevoflurane 2.5% for 15min with 5min of washout before liver IR), and SPPoC group (administration of sevoflurane 2.5% for 15min before ischemia and 20min during reperfusion). Results. All animals showed a decrease in the mean arterial pressure (MAP) and portal vein blood flow during ischemia. After 4h of reperfusion, only the SPPoC group had MAP recovery. In both the SPC and SPPoC groups, there was a decrease in the ALT level and an increase in the bicarbonate and potassium serum levels. Only the SPPoC group showed an increase in the arterial blood ionized calcium level and a decrease in the IL-6 level after liver reperfusion. Therefore, this study demonstrated that sevoflurane preconditioning reduces hepatocellular injury and acid-base imbalance in liver ischemia. Furthermore, sevoflurane postconditioning promoted systemic hemodynamic recovery with a decrease in inflammatory response.