Studying propofol-induced cardioprotection: from mechanism to clinical phenomenon and back again

Excerpt

The concept that anesthetics could potentially impart protective effects on ischemic myocardium was introduced as early as the 1970s in a landmark study by Bland and Lowenstein.1 They demonstrated, in a canine model, that the use of halothane avoided electrocardiographic ST segment elevation and reduced myocardial oxygen consumption during acute coronary occlusion. Subsequent research demonstrated that brief exposure to volatile anesthetics prior to an ischemic insult could reduce the size of a myocardial infarction following experimental coronary artery occlusion.2 Thus, the concept of “anesthesia preconditioning” was born. Four decades after those initial experimental findings, however, scientific studies have yet to demonstrate a clear clinical benefit of “anesthesia preconditioning” in patients undergoing heart surgery. …