Isoflurane suppresses cortical spreading depolarizations compared to propofol - implications for sedation of neurocritical care patients.

Isoflurane suppresses cortical spreading depolarizations compared to propofol - implications for sedation of neurocritical care patients. Exp Neurol. 2013 Nov 15; Authors: Takagaki M, Feuerstein D, Kumagai T, Gramer M, Yoshimine T, Graf R Abstract Sedatives in the neurointensive care unit can strongly influence patients' risks of developing secondary brain damage. In particular, isoflurane, a volatile anesthetic, has been recently re-introduced to the neurointensive care unit, and first clinical studies suggest beneficial effects due to elevation of cerebral blood flow and reduction of metabolism. In contrast, propofol is a commonly used intravenous sedative that reduces cerebral blood flow and intra-cranial pressure. We have here studied the influence of these two sedatives on the occurrence of cortical spreading depolarizations (CSDs), which have emerged over the last decade as a major mechanism of delayed brain injury in stroke and brain trauma, constituting a substantial vascular and metabolic threat to peri-infarct tissue and being associated with poor patient outcome. Two experimental models were tested in Wistar rats anesthetized either with isoflurane or with propofol: KCl-evoked CSDs (n=10) and spontaneous CSDs after occlusion of the middle cerebral artery (n=14). Spatiotemporal patterns of CSD waves were observed by real-time laser speckle imaging of regional cerebral blood flow changes associated with the CSDs. During 30minutes of c...
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research