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A Combination of Sevoflurane Postconditioning and Albumin Increases Bcl-2 Expression After Transient Global Cerebral Ischemia Compared With Either Sevoflurane Postconditioning or Albumin Alone

Jeon, Young-Tae MD; Hwang, Jung-Won MD; Lim, Young-Jin MD; Kim, Ahn-Na MD; Park, Hee-Pyoung MD, PhD

Journal of Neurosurgical Anesthesiology: January 2013 - Volume 25 - Issue 1 - p 43–50
doi: 10.1097/ANA.0b013e31826ca3bc
Laboratory Investigation

Background: The aim of this study was to determine whether a combination of sevoflurane postconditioning and albumin provides additive neuroprotective effects after transient global cerebral ischemia in rats.

Methods: Forty-three rats were assigned to 4 groups: the control group (group C; n=13; 3 died) received no treatment. The albumin group (group A; n=10) received 2 g/kg of albumin for 5 minutes after ischemia. The sevoflurane postconditioning group (group P; n=10) underwent 2 sevoflurane inhalations after ischemia. Each inhalation consisted of 5 minutes of 2.5% sevoflurane and a subsequent washout time of 5 minutes. The sevoflurane postconditioning plus albumin group (group PA; n=10) received additional albumin during sevoflurane postconditioning after ischemia. In all groups, ischemia was induced by a bilateral common carotid artery occlusion along with hemorrhagic hypotension and was maintained for 10 minutes. Histologic and neurobehavioral outcomes were measured 7 days after ischemia in CA1 pyramidal cells of the rat hippocampus.

Results: Groups A, P, and PA showed an improved neurological outcome and contained more viable cells in the hippocampal CA1 area compared with group C (P<0.05). The number of apoptotic cells was significantly reduced in group PA compared with group C (P<0.01). There was a significant difference in the Bcl-2, an antiapoptotic protein, expression between group C and other groups (P<0.01) and between group A or P and group PA (P<0.05).

Conclusions: A combination of sevoflurane postconditioning and albumin increased the level of Bcl-2 expression compared with sevoflurane postconditioning or albumin alone, suggesting their combination might provide additional neuroprotection by decreasing apoptosis.

Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea

Supported by a grant from the Seoul National University Hospital Research Fund (Grant number: 0520080020).

The authors have no conflicts of interest to disclose.

Reprints: Hee-Pyoung Park, MD, PhD, Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehangno, Jongno-gu, Seoul 110-744, South Korea (e-mail:

Received June 8, 2012

Accepted July 31, 2012

© 2013 Lippincott Williams & Wilkins, Inc.