title: Postischemic sevoflurane offers no additional neuroprotective benefit to preischemic dexmedetomidine.
abstract: 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.
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors: Young-Tae
authors: YT
authors: Jeon
authors: Jung-Won
authors: JW
authors: Hwang
authors: Young-Jin
authors: YJ
authors: Lim
authors: Seon-Kyoung
authors: SK
authors: Park
authors: Hee-Pyoung
authors: HP
authors: Park
mesh_terms: D000199:Actins / Q000378:metabolism; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D000818:Animals; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism / Q000502:physiology; D015153:Blotting, Western; D001921:Brain / Q000473:pathology; D020927:Dexmedetomidine / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D020287:In Situ Nick-End Labeling; D002546:Ischemic Attack, Transient / Q000473:pathology* / Q000628:therapy*; D019194:Ischemic Preconditioning / Q000379:methods*; D008738:Methyl Ethers / Q000627:therapeutic use*; D018696:Neuroprotective Agents; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control; D000077149:Sevoflurane; D016610:Tissue Embedding; D051028:bcl-2-Associated X Protein / Q000378:metabolism
chemical_list: D000199:Actins; D018685:Anesthetics, Inhalation; D051017:Apoptosis Regulatory Proteins; D006454:Hemoglobins; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D018696:Neuroprotective Agents; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; D000077149:Sevoflurane; D020927:Dexmedetomidine