Could you summarize the significance of your paper in layman's terms?

“Cardiovascular complications represent a major problem in elderly patients undergoing surgery”

The results presented in this paper unravel the basic mechanisms underlying pharmacological preconditioning (=protection against lethal ischemia) elicited by volatile anesthetics. These fundamental observations are important for clinicians as well as basic scientists interested in cardiac protection (translational research).

Volatile anesthetics may not only be used perioperatively to protect the heart of high-risk surgical patients but also may be administered in patients undergoing coronary interventions. As volatile anesthetics further induce a “second window of protection” (=protection occurring 24 hrs after the application and lasting for 3-4 days), they may be used in many clinical settings to prevent cardiovascular complications.

Volatile anesthetics are protective at subanesthetic concentrations, as demonstrated in my publication. At these concentrations, no side effects will occur.

Cardiovascular complications represent a major problem in elderly patients undergoing surgery. Since 1997, my research has focused on cardioprotective treatments such as pharmacological preconditioning to reduce perioperative cardiovascular complications.

My paper is based on the following findings:

1. Mitochondria are the main sites of protection elicited by volatile anesthetics.

2. The publication shows for the first time that volatile anesthetics prime or activate mitochondrial ATP-dependent potassium channels. Additional experiments show that this activation is clearly associated with significant cell protection.

3. Multiple signaling pathways are involved in establishing the protective cellular state. These include activation of protein kinase C, nitric oxide, adenosine, and Gi-protein coupled receptors.

Privatdozent Michael Zaugg
Institute of Anesthesiology University Hospital Zurich and
Institute of Pharmacology University Zurich
Zurich, Switzerland