[Effects of ketamine and midazolam combination anesthesia on focal cerebral ischemia injury in rats].
OBJECTIVE
We investigated the effects of anesthesia with ketamine and midazolam on focal cerebral ischemia injury, and evaluated the neuroprotective properties of this combination during surgical procedures.


METHODS
Thirty male Sprague-Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO) under ketamine or ketamine-midazolam intraperitoneal anesthesia (n = 15 each). The neurological scoring was performed to determine functional impairment of the brain at 4 h after MCAO. TTC staining of brain slices was used to measure infarct size of the brain at 24 h after MCAO. At day 3 after MCAO, TUNEL staining was employed to detect apoptotic cells in the penumbra.


RESULTS
Although neurological scoring (1.57 +/- 0.65 vs 1.74 +/- 0.52) was not significantly different between ketamine and ketamine-midazolam groups (P > 0.05), infarct size and apoptotic cell density in the penumbra were significantly lower in the ketamine-midazolaml group than those in the ketaminel group [infarct size: (24.1 +/- 4.63)% vs (38.48 +/- 4.18)%; apoptotic cells density: (178 +/- 23) cells/mm2 vs (258 +/- 15) cells/mm2, P < 0.05], respectively.


CONCLUSIONS
The above findings suggested that ketamine and midazolam combination might provide neuroprotection during surgical procedures that pose risk for ischemic cerebral injury.
Zhang
Peng-Bo
PB
Research Center for Neuroscience, Environment and Genes Related to Diseases, Key Laboratory of Education Ministry, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, China.
Liu
Yong
Y
Li
Jie
J
Chen
Xin-lin
XL
Tian
Ying-fang
YF
Sun
Jian-jun
JJ
Liu
Jian-xin
JX
D000758:Anesthesia; D019162:Anesthetics, Combined; D000818:Animals; D002545:Brain Ischemia / Q000473:pathology*; D007649:Ketamine; D008297:Male; D008874:Midazolam; D018696:Neuroprotective Agents / Q000494:pharmacology*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley
D019162:Anesthetics, Combined; D018696:Neuroprotective Agents; D007649:Ketamine; D008874:Midazolam