title: Comparison of the neuroprotective effects and recovery profiles of isoflurane, sevoflurane and desflurane as neurosurgical pre-conditioning on ischemia/reperfusion cerebral injury.
abstract: BACKGROUND
  There are a few reports regarding the comparison of these anesthetic agents, but previous studies mainly focus on the veterinary anesthesiology. Less attention has been focused comparing the effectiveness of these inhalational anesthetic agents in neurosurgery. This lack of interest is regretful particularly considering the fact that anesthetics during neurosurgery are an issue of extreme sensitivity and subtlety, where the cerebral oxygenation process plays a significant role in the neuroprotective mechanisms.
  
  
  OBJECTIVE
  The purpose of this retrospective study is to contribute to the existing knowledge of the comparative studies of the volatile anesthetic agents such as isoflurane, sevoflurane and desflurane by evaluating the maintenance and emergence characteristics after volatile anesthetics-induced preconditioning with isoflurane, sevoflurane or desflurane for inpatient ischemia/reperfusion cerebral injury during cerebral or neural surgeries.
  
  
  METHODS
  The aim was to investigate their neuroprotective mechanisms and effects by analyzing and comparing the superiority of each agent in a Chinese patient population, in terms of faster emergence, and early and intermediate recovery. The intraoperative haemodynamic profiles and postoperative adverse effects of these three agents were also systematically analyzed.
  
  
  RESULTS
  We found that sevoflurane, when compared with isoflurane and desflurane, provided anesthesia with similar hemodynamic stability but allowed for a smoother, more rapid emergence and better quality of induction and recovery to surgical patients under clinical conditions, particularly to those who were experiencing substantial cerebral vasodilation.
  
  
  CONCLUSIONS
  Sevoflurane offers several advantages, including a relative lack of airway irritation, a more rapid onset and recovery, and greater hemodynamic stability than other potent inhaled agents. These properties would appear to afford sevoflurane significant clinical potential.
authors.affiliation: Department of Anesthesia, Affiliated Hospital of Weifang Medical University Weifang 261053, Shandong province, China.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Shan
authors.affiliation: Department of Anesthesia, Affiliated Hospital of Weifang Medical University Weifang 261053, Shandong province, China.
authors.forename: Lianmei
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Anesthesia, Weifang Medical University Weifang 261053, Shandong province, China.
authors.forename: Dewei
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Anesthesia, Weifang Medical University Weifang 261053, Shandong province, China.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Li
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000187:drug effects; D000077335:Desflurane; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015427:Reperfusion Injury / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D008738:Methyl Ethers; D018696:Neuroprotective Agents; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane
keywords: Isoflurane; cerebral oxygenation; desflurane; recovery; sevoflurane