Effect of nitroglycerin on spinal cord ischemia after thoracic aortic cross-clamping

Simpson, Joseph I.; Eide, Thomas R.; Schiff, Gerald A.; Newman, Sheldon B.; Clagnaz, John F.; Hossain, Imtiaz; Schulman, Steven B.; Gropper, J.

doi:10.1016/0003-4975(95)00829-2

Cited by 18 publications

(5 citation statements)

References 14 publications

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“…Nitrates and other nitric oxide (NO) donors have been reported to be harmful rather than protective during spinal cord ischemia, despite their vasodilatory effects. 12 In the brain it has been reported that protective vascular effects of endothelial NO outweigh the neurotoxic potential of neuronal NO only in the very early stages of ischemia, and large amounts of NO produced by inducible NO synthase during the late reperfusion period contribute to the delayed progression of the damage. 13 In the heart Ohno and colleagues 14 have reported that nicorandil has a protective effect if it is administered before ischemia but not if it is administered after ischemia, and this effect is mediated through the activation of KATP.…”

Section: Discussionmentioning

confidence: 99%

The adenosine triphosphate–sensitive potassium channel opener nicorandil protects the ischemic rabbit spinal cord

Wakamatsu

Shiiya

Kunihara

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

The adenosine triphosphate–sensitive potassium channel opener nicorandil protects the ischemic rabbit spinal cord

Wakamatsu

Shiiya

Kunihara

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

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“…44 The use of NTG to control proximal arterial hypertension is also problematic. 45 When compared with induced hypovolemia (exsanguination), NTG use resulted in significant decreases in SCPP, which was primarily attributable to decreases in distal aortic pressure (ie, there were no differences in CSF pressures between the animals that were made hypovolemic vs those that received NTG). NTG also resulted in worse neurological outcomes.…”

Section: Hemodynamic Changes Associated With Aortic Clamping and Unclampingmentioning

confidence: 98%

Anesthetic Consideration for Descending Thoracic Aortic Aneurysm Repair

Kahn

Stone

Moskowitz

2007

Semin Cardiothorac Vasc Anesth

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Anesthesia for surgery of the aorta poses some of the most difficult challenges for anesthesiologists. Major hemodynamic and physiologic stresses and sophisticated techniques of extracorporeal support are superimposed on patients with complex medical disease states. In this review, etiologies, natural history, and surgical techniques of thoracic aortic aneurysm are presented. Anesthetic considerations are discussed in detail, including the management of distal perfusion using partial cardiopulmonary bypass. Considerations of spinal cord protection, including management of proximal hypertension, cerebral spinal fluid drainage, and pharmacological therapies, are presented.

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“…2 Neutrophils have also been suggested to contribute and aggravate this socalled`ischemia-reperfusion (IR) injury' to the spinal cord. 3,4 Many agents such as iloprost, 2 nitroglycerin, 5 phenytoin, 6 steroids, 7 memantine, 8 trimetazidine, 9 riluzole, 10 aprotinin 11 and various treatment modalities such as ischemic pretreatment 12,13 and hypothermia 14,15 have been suggested to prevent this complication. Another pharmacological agent with the potential for altering the ischemia-reperfusion injury is the methylxanthine derivate, Pentoxifylline (PTX); this has been used in many types of cerebrovascular disease including transient ischemic attacks, sequelae of cerebral thrombosis and hemorrhage, and chronic ischemic disorders beside the experiments on IR injury.…”

Section: Introductionmentioning

confidence: 99%

Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits

et al. 2002

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Study design: Occlusion of the infrarenal abdominal aorta with administration of pentoxifylline was applied to adult rabbits, followed by removal of aortic clamp and reperfusion. Tissue levels of cytokines, lipid peroxides, and antioxidant enzymes were assayed and compared within groups. Objectives: To examine the e ect of pentoxifylline (PTX) on cytokine levels, lipid peroxidation, and antioxidant enzymes in a rabbit model of spinal cord ischemia-reperfusion injury induced by aortic occlusion. Setting: Isparta, Turkey. Methods: Rabbits were randomly allocated into four groups of sham laparotomy (SHAM), sham laparotomy with PTX administration (SHAM+PTX), aortic occlusion and reperfusion (AOR), aortic occlusion and reperfusion with PTX administration (AOR+PTX). An intravenous bolus of 50 mg/kg PTX was given just before aortic cross clamping. An atraumatic microvascular clamp was then placed on the abdominal aorta immediately distal to the left renal artery for 30 min. PTX was infused at a rate of 0.5 mg/kg/min during the aortic occlusion. Animals were subjected to 120 min of reperfusion after removal of the aortic clamp. All animals were sacri®ced at the end of reperfusion. The lumbosacral segments of spinal cords were quickly harvested and stored at 7788C for biochemical assays of IL-6, TNF-a, MDA, SOD, and CAT levels. Di erences among groups were analyzed by one-way analysis of variance followed by a post hoc Tukey's honestly signi®cant di erence test. Results: No di erences in mean levels of IL-6, TNF-a, MDA, SOD, and CAT were noted between SHAM and SHAM+PTX groups (P40.05). There was a signi®cant increase in all biochemical parameters in the AOR group (P50.05). Administration of PTX signi®cantly attenuated the levels of all biochemical parameters in the AOR+PTX group (P50.05). Conclusion: PTX pretreatment attenuated ischemia-reperfusion induced spinal cord injury in a rabbit model, in terms of biochemical parameters of ischemia and reperfusion.

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Effect of nitroglycerin on spinal cord ischemia after thoracic aortic cross-clamping

Cited by 18 publications

References 14 publications

The adenosine triphosphate–sensitive potassium channel opener nicorandil protects the ischemic rabbit spinal cord

The adenosine triphosphate–sensitive potassium channel opener nicorandil protects the ischemic rabbit spinal cord

Anesthetic Consideration for Descending Thoracic Aortic Aneurysm Repair

Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits

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