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Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice.

Publication ,  Journal Article
Homi, HM; Mixco, JM; Sheng, H; Grocott, HP; Pearlstein, RD; Warner, DS
Published in: Anesthesiology
November 2003

BACKGROUND: Volatile anesthetics provide protection in experimental models of global cerebral ischemia. To date, all models evaluated have included profound systemic arterial hypotension as a component of the ischemic insult. This study was designed to determine if isoflurane protection persists in a global insult devoid of hypotension. METHODS: C57BL/6J mice having a high incidence of posterior communicating artery atresia were anesthetized with isoflurane (1.2%) or fentanyl/N2O and subjected to bilateral carotid artery occlusion for 15 min or 20 min with normotension (80-110 mmHg mean arterial pressure) or for 10 min with hypotension (35 mmHg mean arterial pressure). Three days later, neurologic function and histologic damage were assessed. Other mice underwent measurement of intraischemic cerebral blood flow (4-iodo-N-methyl-[14C]antipyrine autoradiography) or plasma norepinephrine. RESULTS: Isoflurane reduced the percentage of hippocampal CA1 dead neurons (e.g., 10 min bilateral carotid occlusion + hypotension: 43 +/- 18 (isoflurane) vs. 67 +/- 20 (fentanyl/N2O), P = 0.003; 20 min bilateral carotid occlusion + normotension: 49 +/- 27 (isoflurane) vs. 71 +/- 22 (fentanyl/N2O), P = 0.003). Isoflurane also reduced CA3 damage and improved neurologic function under all conditions. Intraischemic forebrain blood flow was similar during bilateral carotid occlusion plus normotension for the two anesthetic states. Plasma norepinephrine values were greater when hypotension was added to the ischemic insult. CONCLUSIONS: Isoflurane resulted in improved neurologic function and reduced histologic damage regardless of the presence or absence of systemic hypotension during the ischemic insult. This indicates that beneficial effects of isoflurane are most likely attributable to direct effects at the neuronal level as opposed to indirect effects resulting from interactions with profound hypotension.

Duke Scholars

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

November 2003

Volume

99

Issue

5

Start / End Page

1145 / 1151

Location

United States

Related Subject Headings

  • Norepinephrine
  • Neuroprotective Agents
  • Mice, Inbred C57BL
  • Mice
  • Male
  • Isoflurane
  • Image Processing, Computer-Assisted
  • Hypotension, Controlled
  • Brain Ischemia
  • Brain Chemistry
 

Citation

APA
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ICMJE
MLA
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Homi, H. M., Mixco, J. M., Sheng, H., Grocott, H. P., Pearlstein, R. D., & Warner, D. S. (2003). Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice. Anesthesiology, 99(5), 1145–1151. https://doi.org/10.1097/00000542-200311000-00022
Homi, H Mayumi, Javier M. Mixco, Huaxin Sheng, Hilary P. Grocott, Robert D. Pearlstein, and David S. Warner. “Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice.Anesthesiology 99, no. 5 (November 2003): 1145–51. https://doi.org/10.1097/00000542-200311000-00022.
Homi HM, Mixco JM, Sheng H, Grocott HP, Pearlstein RD, Warner DS. Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice. Anesthesiology. 2003 Nov;99(5):1145–51.
Homi, H. Mayumi, et al. “Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice.Anesthesiology, vol. 99, no. 5, Nov. 2003, pp. 1145–51. Pubmed, doi:10.1097/00000542-200311000-00022.
Homi HM, Mixco JM, Sheng H, Grocott HP, Pearlstein RD, Warner DS. Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice. Anesthesiology. 2003 Nov;99(5):1145–1151.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

November 2003

Volume

99

Issue

5

Start / End Page

1145 / 1151

Location

United States

Related Subject Headings

  • Norepinephrine
  • Neuroprotective Agents
  • Mice, Inbred C57BL
  • Mice
  • Male
  • Isoflurane
  • Image Processing, Computer-Assisted
  • Hypotension, Controlled
  • Brain Ischemia
  • Brain Chemistry