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Sevoflurane preconditioning against focal cerebral ischemia: inhibition of apoptosis in the face of transient improvement of neurological outcome.

AbstractBACKGROUND:
Preconditioning the brain with volatile anesthetics seems to be a viable option for reducing ischemic cerebral injury. However, it is uncertain whether this preconditioning effect extends over a longer period of time. The purpose of this study was to determine if sevoflurane preconditioning offers durable neuroprotection against cerebral ischemia.
METHODS:
Rats (Sprague-Dawley) were randomly allocated to two groups: nonpreconditioned control group (n = 44) and preconditioned group (n = 45) exposed to 2.7 vol% sevoflurane (45 min) 60 min before surgery. Animals in both groups were anesthetized with 3.0 vol% sevoflurane and subjected to transient middle cerebral artery occlusion. After 60 min of awake focal ischemia, the filament was removed. Functional neurologic outcome (range 0-18; 0 = no deficit), cerebral infarct size (Nissl staining), and apoptosis (Terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate nick-end labeling; cleaved caspase-3 staining) were evaluated at 3, 7, and 14 days after ischemia.
RESULTS:
Sevoflurane preconditioning significantly improved functional outcome and reduced infarct volume (109 +/- 43 vs. 148 +/- 56 mm(3)) 3 days after ischemia compared to the control group. However, after 7- and 14-day recovery periods, no significant differences were observed between groups. The number of apoptotic cells was significantly lower in the preconditioned group than in the control group after 3- and 7-day recovery periods. Fourteen days after ischemia, no differences were observed between groups.
CONCLUSION:
In this model of transient focal cerebral ischemia, sevoflurane preconditioning induced effective but transient neuroprotective effects. Sevoflurane preconditioning also decreased ischemia-induced apoptosis in a more sustained way because it was observed up to 7 days after injury.
AuthorsJean-Laurent Codaccioni, Lionel J Velly, Chahrazad Moubarik, Nicolas J Bruder, Pascale S Pisano, Benjamin A Guillet
JournalAnesthesiology (Anesthesiology) Vol. 110 Issue 6 Pg. 1271-8 (Jun 2009) ISSN: 1528-1175 [Electronic] United States
PMID19417596 (Publication Type: Journal Article)
Chemical References
  • Anesthetics, Inhalation
  • Methyl Ethers
  • Neuroprotective Agents
  • sevoflurane
Topics
  • Anesthetics, Inhalation (pharmacology)
  • Animals
  • Apoptosis (drug effects)
  • Behavior, Animal (physiology)
  • Brain Ischemia (pathology, physiopathology, prevention & control)
  • DNA Fragmentation
  • In Situ Nick-End Labeling
  • Infarction, Middle Cerebral Artery (pathology, prevention & control)
  • Ischemic Attack, Transient (physiopathology, prevention & control)
  • Ischemic Preconditioning
  • Methyl Ethers (pharmacology)
  • Nervous System Diseases (pathology, psychology)
  • Neuroprotective Agents
  • Rats
  • Rats, Sprague-Dawley

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