Application of volatile anesthetics greatly alters modern medicine. There are obvious advantages of volatile anesthetics such as strong anesthetic potency, rapid onset and elimination through respiration system. Isoflurane is one of the most widely used volatile anesthetics in clinic. Emulsified isoflurane, the emulsion of isoflurane, is a novel intravenous general anesthetic. With the development of emulsified isoflurane in the past fifteen years, its utility has spread from intravenous general anesthesia to various fields including regional anesthesia, organ protection, as well as anesthetic pharmacological study. In this review, we will summarize literatures of emulsified isoflurane about its history, clinical application and future potential utility in the above mentioned fields.
Corresponding Author(s):
Liu Jin,Email:scujinliu@yahoo.com.cn
引用本文:
. A novel intravenous general anesthetic--- emulsified isoflurane: from bench to bedside[J]. Frontiers of Medicine, 2012, 6(4): 381-387.
Cheng Zhou, Jin Liu. A novel intravenous general anesthetic--- emulsified isoflurane: from bench to bedside. Front Med, 2012, 6(4): 381-387.
Mazze RI. Methoxyflurane revisited: tale of an anesthetic from cradle to grave. Anesthesiology 2006; 105(4): 843–846 doi: 10.1097/00000542-200610000-00031 pmid:17006084
2
Habibollahi P, Mahboobi N, Esmaeili S, Safari S, Dabbagh A, Alavian SM. Halothane-induced hepatitis: a forgotten issue in developing countries. Hepat Mon 2011; 11(1): 3–6 pmid:22087107
3
Brasil LJ, San-Miguel B, Kretzmann NA, Amaral JL, Zettler CG, Marroni N, González-Gallego J, Tu?ón MJ. Halothane induces oxidative stress and NF-kappaB activation in rat liver: protective effect of propofol. Toxicology 2006; 227(1–2): 53–61 doi: 10.1016/j.tox.2006.07.013 pmid:16965849
4
Lucchinetti E, Schaub MC, Zaugg M. Emulsified intravenous versus evaporated inhaled isoflurane for heart protection: old wine in a new bottle or true innovation? Anesth Analg 2008; 106(5): 1346–1349 doi: 10.1213/ane.0b013e31816d1661 pmid:18420843
Sandison JW, Sivapragasam S, Hayes JA, Woo-Ming MO. An experimental study of pulmonary damage associated with intravenous injection of halothane in dogs. Br J Anaesth 1970; 42(5): 419–424 doi: 10.1093/bja/42.5.419 pmid:5431541
8
Sutton J, Harrison GA, Hickie JB. Accidental intravenous injection of halothane. Case report. Br J Anaesth 1971; 43(5): 513–520 doi: 10.1093/bja/43.5.513 pmid:4933885
9
Krantz JC Jr, Cascorbi HF, Rudo FG. Anesthesia. 64. The intravenous administration of methoxyflurane (Penthrane) emulsions in animals and man. Anesth Analg 1962; 41: 257–262 pmid:14459330
10
Cascorbi HF, Helrich M, Krantz JC Jr, Baker LR, Rozman RS, Rudo FG. Hazards of methoxyflurane emulsions in man. Anesth Analg 1968; 47(5): 557–559 doi: 10.1213/00000539-196809000-00019 pmid:4876884
11
Eger RP, MacLeod BA. Anaesthesia by intravenous emulsified isoflurane in mice. Can J Anaesth 1995; 42(2): 173–176 doi: 10.1007/BF03028273 pmid:7720163
12
Ma HX, Li J, Yang ZB, Yang XL, Liu AJ, Yang JW, Rao Y, Luo NF, Zhang WS, Liu J. Comparison of emulsified isoflurane and propofol with intravenous injection in Beagle dogs. Chin J Anesthesiol (Zhonghua Ma Zui Xue Za Zhi) 2006; 26(9): 862–863 (in Chinese)
13
Johannesson G, Alm P, Biber B, Lennander O, Werner O. Halothane dissolved in fat as an intravenous anaesthetic to rats. Acta Anaesthesiol Scand 1984; 28(4): 381–384 doi: 10.1111/j.1399-6576.1984.tb02081.x pmid:6435378
14
Fast JP, Perkins MG, Pearce RA, Mecozzi S. Fluoropolymer-based emulsions for the intravenous delivery of sevoflurane. Anesthesiology 2008; 109(4): 651–656 doi: 10.1097/ALN.0b013e31818630ff pmid:18813044
15
Jee JP, Parlato MC, Perkins MG, Mecozzi S, Pearce RA. Exceptionally stable fluorous emulsions for the intravenous delivery of volatile general anesthetics. Anesthesiology 2012; 116(3): 580–585 doi: 10.1097/ALN.0b013e3182475d4d pmid:22354241
16
Jia MX, Luo NF, Zhang WS, Zhou JX, Liu J. Partition coefficients of volatile anesthetics in lipid emulsion and its components. West China J Pharm Sci (Hua Xi Yao Xue Za Zhi) 2004; 19(6): 422–425 (in Chinese)
17
Zhou JX, Liu J. The effect of temperature on solubility of volatile anesthetics in human tissues. Anesth Analg 2001; 93(1): 234–238 doi: 10.1097/00000539-200107000-00047 pmid:11429373
18
Zhou JX, Liu YQ, Liu J. Combined effect of hypothermia and crystalloid hemodilution on the solubility of volatile anesthetics in human blood. Chin Med J (Engl) 2002; 115(7): 1014–1019 pmid:12150733
19
Zhou JX, Luo NF, Liu J. Saturated concentration of emulsified isoflurane at 20°C and its anesthetic potency for intravenous injection in rats. J Beijing Med (Bei Jing Yi Xue) 2004; 26(6): 376–378 (in Chinese)
20
Zhou JX, Luo NF, Liang XM, Liu J. The efficacy and safety of intravenous emulsified isoflurane in rats. Anesth Analg 2006; 102(1): 129–134 doi: 10.1213/01.ane.0000189612.24147.07 pmid:16368817
21
Ma HX, Yang ZB, Yang XL, Liu AJ, Yang JW, Rao Y, Luo NF, Zhang WS, Liu J. Determination of intravenous emulsified isoflurane MAC and its circulatory effects in Beagle dogs. J Clin Anesthesiol (Lin Chuang Ma Zui Xue) 2007; 23(10): 836–838 (in Chinese)
22
Yang XL, Ma HX, Yang ZB, Liu AJ, Luo NF, Zhang WS, Wang L, Jiang XH, Li J, Liu J. Comparison of minimum alveolar concentration between intravenous isoflurane lipid emulsion and inhaled isoflurane in dogs. Anesthesiology 2006; 104(3): 482–487 doi: 10.1097/00000542-200603000-00015 pmid:16508395
23
Rao Y, Wang YL, Zhang WS, Yang XL, Ma HX, Yang JW, Liu AJ, Yang ZB, Liu J. The hemolytic effect of emulsified isoflurane after single bolus in Beagle dogs. Chin J Anesthesiol (Zhonghua Ma Zui Xue Za Zhi) 2006; 7(26): 666–667 (in Chinese)
24
Yang ZB, Yang XL, Zhang WS, Ma HX, Liu AJ, Rao Y, Yang JW, Liu J. Toxicity study on long-term intravenous administration of emulsified isoflurane in rats. J Clin Anesthesiol (Lin Chuang Ma Zui Xue) 2008; 24(9): 112–115 (in Chinese)
25
Sun HF, Wang QY, Liang XM, Zhang ZX, Liu J. The efficacy and safety of emulsified isoflurane after intraperitoneal injection in rats. Chin J Anesthesiol (Zhonghua Ma Zui Xue Za Zhi) 2004; 24(1): 51–53 (in Chinese)
26
Lin HX, Luo NF, Liu J, Yang J, Li Q. The sedative and hypnotic effects and safety of oral emulsified isoflurane in rats. J Sichuan Univ (Med Sci Ed) (Sichuan Da Xue Xue Bao Yi Xue Ban) 2010; 41(5): 862–864, 887 (in Chinese) pmid:21302459
27
Yang JW, Yi ML, Chai YF, Zhang WS, Liu J. Fentanyl hypnotic interaction with emulsified isoflurane. J Sichuan Univ (Med Sci Ed) (Sichuan Da Xue Xue Bao Yi Xue Ban) 2007; 38(6): 973–976 (in Chinese) pmid:18095599
28
Yang JW, Chen Y, Gao AL, Zhang WS, Liu J. Interaction between fentanyl with emulsified isoflurane. West China J Pharm Sci (Hua Xi Yao Xue Za Zhi) 2007; 22(5): 529–532 (in Chinese)
29
Haynes DH, Kirkpatrick AF. Long duration local anesthesia with lecithin-coated microdroplets of methoxyflurane: studies with human skin. Reg Anesth 1991; 16(3): 173–180 pmid:1883776
30
Kirkpatrick AF, Lavallee-Grey M, Haynes DH. Long duration local anesthesia with lecithin-coated microdroplets of methoxyflurane: studies with rat skin. Reg Anesth 1991; 16(3): 164–172 pmid:1883775
31
Haynes DH, Kirkpatrick AF. Ultra-long-duration local anesthesia produced by injection of lecithin-coated methoxyflurane microdroplets. Anesthesiology 1985; 63(5): 490–499 doi: 10.1097/00000542-198511000-00004 pmid:3840340
32
Chai YF, Yang J, Liu J, Song HB, Yang JW, Liu SL, Zhang WS, Wang QW. Epidural anaesthetic effect of the 8% emulsified isoflurane: a study in rabbits. Br J Anaesth 2008; 100(1): 109–115 doi: 10.1093/bja/aem298 pmid:18042558
33
Zhou C, Wu W, Liu J, Liao DQ, Kang Y, Chen XD. Inhibition of voltage-gated sodium channels by emulsified isoflurane may contribute to its subarachnoid anesthetic effect in beagle dogs. Reg Anesth Pain Med 2011; 36(6): 553–559 pmid:21989153
34
Zhou C, Gan J, Liu J, Luo WJ, Zhang WS, Chai YF. The interaction between emulsified isoflurane and lidocaine is synergism in intravenous regional anesthesia in rats. Anesth Analg 2011; 113(2): 245–250 doi: 10.1213/ANE.0b013e31821e9797 pmid:21596886
35
Li Z, Yang J, Liu J, Gong CY, Gan J, Zhang X, Luo WJ, Li GH. Reversible conduction block in isolated toad sciatic nerve by emulsified isoflurane. Anesth Analg 2010; 110(4): 1024–1029 doi: 10.1213/ANE.0b013e3181d2732f pmid:20357146
36
Chiari PC, Pagel PS, Tanaka K, Krolikowski JG, Ludwig LM, Trillo RA Jr, Puri N, Kersten JR, Warltier DC. Intravenous emulsified halogenated anesthetics produce acute and delayed preconditioning against myocardial infarction in rabbits. Anesthesiology 2004; 101(5): 1160–1166 doi: 10.1097/00000542-200411000-00016 pmid:15505452
37
Liu XL, Liu J. Effects of emulsified isoflurane and intralipid on ischemia-reperfusion injury in isolated rat heart. West China J Pharm Sci (Hua Xi Yao Xue Za Zhi) 2007; 22(5): 525–527 (in Chinese)
38
Hu Q, Wang J, Chang X, Long C. Cardioprotective effects of emulsified isoflurane strengthened cardioplegia on ischemia-reperfusion injury in isolated rat hearts. J Clin Med Pract (Shi Yong Lin Chuang Yi Yao Za Zhi) 2009; 13(1): 5–8 (in Chinese)
39
Huang H, Zhang W, Liu S, Yanfang C, Li T, Liu J. Cardioprotection afforded by St Thomas solution is enhanced by emulsified isoflurane in an isolated heart ischemia reperfusion injury model in rats. J Cardiothorac Vasc Anesth 2010; 24(1): 99–103 doi: 10.1053/j.jvca.2009.10.016 pmid:20123239
40
Liu SL, Liu J. Apoptosis mechanism of intralipid postconditioning to reduce ischemia reperfusion injury of isolated rat hearts. J Sichuan Univ (Med Sci Ed) (Sichuan Da Xue Xue Bao Yi Xue Ban) 2007; 38(4): 663–666 (in Chinese) pmid:17718436
41
Chen YQ, Jin XJ, Dai ZP, Zhang WS, Liu J. Effects of emulsified isoflurane induced preconditioning on cardiac hemodynamic during myocardiac ischemia-reperfusion injury in rabbits. J Anesthesiol Resusc (Guo Ji Ma Zui Xue Yu Fu Su Za Zhi) 2006; 27(4): 224–226 (in Chinese)
42
Rao Y, Wang YL, Zhang WS, Liu J. Emulsified isoflurane produces cardiac protection after ischemia-reperfusion injury in rabbits. Anesth Analg 2008; 106(5): 1353–1359 doi: 10.1213/ane.0b013e3181679347 pmid:18420844
43
Rao Y, Wang YL, Chen YQ, Zhang WS, Liu J. Protective effects of emulsified isoflurane after myocardial ischemia-reperfusion injury and its mechanism in rabbits. Chin J Traumatol 2009; 12(1): 18–21 pmid:19159511
44
Yang MC, Chen YP, Cao DJ, Qian X, Li P. The optimal concentration for the protective effect of emulsified isoflurane on the neonatal rat cardiac myocytes hypoxia/reoxygenation injury of primary culture. J Sichuan Univ (Med Sci Ed) (Sichuan Da Xue Xue Bao Yi Xue Ban) 2009; 40(6): 1075–1077 , 1090 (in Chinese) pmid:20067123
45
Hu ZY, Luo NF, Liu J. The protective effects of emulsified isoflurane on myocardial ischemia and reperfusion injury in rats. Can J Anaesth 2009; 56(2): 115–125 doi: 10.1007/s12630-008-9016-3 pmid:19247759
46
Tan XQ, Chen YP, Zhang WS, Liu J. Effect of emulsified isoflurane on myocardial apoptosis and expressions of bcl-2 and bax induced by hypoxia-reoxygenation. J Third Mil Med Univ (Di San Jun Yi Da Xue Xue Bao) 2008; 30(17): 1611–1614 (in Chinese)
47
Tan XQ, Chen YP. Emulsified isoflurane protects hypoxia/reoxgenation injury in cultured neonatal rat myocardial cells by suppressing caspase-3 expression. J Third Mil Medical Univ (Di San Jun Yi Da Xue Xue Bao) 2009; 31(14): 1341–1344 (in Chinese)
48
Lv H, Yang LQ, Yu WF, Li Q, Ren HM, Zhu M, Xu LY. Protection of liver against ischemia/reperfusion injury by Kupffer cell mediated emulsified isoflurane preconditioning: experiment with rats. Natl Med J China (Zhonghua Yi Xue Za Zhi) 2007; 35(87): 2468–2471 (in Chinese)
49
Zhang L, Luo N, Liu J, Duan Z, Du G, Cheng J, Lin H, Li Z. Emulsified isoflurane preconditioning protects against liver and lung injury in rat model of hemorrhagic shock. J Surg Res 2011; 171(2): 783–790 doi: 10.1016/j.jss.2010.06.037 pmid:20850773
50
Lv X, Wang ZM, Huang SD, Song SH, Wu FX, Yu WF. Emulsified isoflurane preconditioning reduces lung injury induced by hepatic ischemia/reperfusion in rats. Int J Med Sci 2011; 8(5): 353–361 doi: 10.7150/ijms.8.353 pmid:21698053
51
Wang Y, Zhang WS, Deng L, Liu J. Protective effect of 8% emulsified isoflurane against focal cerebral ischemia-reperfusion injury in rats. West China J Pharm Sci (Hua Xi Yao Xue Za Zhi) 2008; 23(2): 140–142 (in Chinese)
52
Wang YL, Wang ZP, Zhu W. Effect of preconditioning with different doses of emulsified isoflurane on focal cerebral ischemia-reperfusion injury in rats. Chin J Anesthesiol (Zhonghua Ma Zui Xue Za Zhi) 2010; 30(10): 1243–1246 (in Chinese)
53
Yang J, Chai YF, Gong CY, Li GH, Luo N, Luo NF, Liu J. Further proof that the spinal cord, and not the brain, mediates the immobility produced by inhaled anesthetics. Anesthesiology 2009; 110(3): 591–595 doi: 10.1097/ALN.0b013e3181974bfd pmid:19212265
54
Yang J, Li Z, Gong CY, Chai YF, Li T, Li GH, Luo N, Luo NF, Zhu L, Liu J. A model for the preferential delivery of isoflurane to the spinal cord of the goat. Vet J 2011; 187(2): 239–244 doi: 10.1016/j.tvjl.2010.01.004 pmid:20739204
55
Hang LH, Shao DH, Yang YH, Dai TJ, Zeng YM. Spinal alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors may mediate the analgesic effects of emulsified halogenated anaesthetics. Clin Exp Pharmacol Physiol 2007; 34(11): 1121–1125 pmid:17880364
56
Hang LH, Dai TJ, Zeng YM. Spinal N-methyl-D-aspartate receptors may mediate the analgesic effects of emulsified halogenated anesthetics. Pharmacology 2006; 76(3): 105–109 doi: 10.1159/000090291 pmid:16352921
57
Chen Y, Dai TJ, Zeng YM. Strychnine-sensitive glycine receptors mediate the analgesic but not hypnotic effects of emulsified volatile anesthetics. Pharmacology 2007; 80(2-3): 151–157 doi: 10.1159/000103255 pmid:17534125