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Postischemic Sevoflurane Offers No Additional Neuroprotective Benefit to Preischemic Dexmedetomidine

Jeon, Young-Tae MD; Hwang, Jung-Won MD; Lim, Young-Jin MD; Park, Seon-Kyoung MD; Park, Hee-Pyoung MD, PhD

Journal of Neurosurgical Anesthesiology: April 2013 - Volume 25 - Issue 2 - p 184–190
doi: 10.1097/ANA.0b013e3182764d2a
Laboratory Investigations
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Background: We designed this study to determine whether a combination of dexmedetomidine and sevoflurane postconditioning provides additive neuroprotection in a rat model of transient global cerebral ischemia.

Methods: Forty rats were randomly allocated to 4 groups. Control group (group C, n=10) received no treatment. Dexmedetomidine group (group D, n=10) received dexmedetomidine of 100 μg/kg intraperitoneally 30 minutes before ischemia. 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 10 minutes. Sevoflurane postconditioning plus dexmedetomidine group (group PD, n=10) received received dexmedetomidine and 2 sevoflurane inhalations 30 minutes before ischemia and after ischemia, respectively. In all the groups, ischemia was induced by a bilateral common carotid artery occlusion plus hemorrhagic hypotension and was maintained for 8 minutes. Histologic outcomes and apoptosis-related proteins were measured 7 days after ischemia in the CA1 area of the rat hippocampus.

Results: Groups D, P, and PD contained more viable cells and less apoptotic cells in the hippocampal CA1 area than group C (P<0.01). There was a significant difference in the Bax and Bcl-2 expression between group C and other groups (P<0.05). But the number of viable and apoptotic cells, and the Bax and Bcl-2 expression were not statistically different between group D or P and group PD.

Conclusions: A combination of preischemic dexmedetomidine and sevoflurane postconditioning provides no additional neuroprotective benefit over preischemic dexmedetomidine or sevoflurane postconditioning alone.

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

Supported by a Grant from the Seoul National University Hospital Research Fund (Grant Number: 0420100400).

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, Korea (e-mail: hppark@snu.ac.kr).

Received July 23, 2012

Accepted September 26, 2012

© 2013 by Lippincott Williams & Wilkins