Neuroprotective effect of volatile anesthetic agents: Molecular mechanisms

Gerald A. Matchett, Martin W. Allard, Robert D. Martin, John H. Zhang

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Introduction: Intra-operative cerebral ischemia can be catastrophic, and volatile anesthetic agents have been recognized for their potential neuroprotective properties since the 1960s. In this review, we examine the neuroprotective effects of five volatile anesthetic agents in current or recent clinical use: isoflurane, sevoflurane, desflurane, halothane and enflurane. Methods: A review of publications in the National Library of Medicine and National Institutes of Health database from 1970 to 2007 was conducted. Results: Volatile anesthetic agents have been shown to be neuroprotective in multiple animal works of ischemic brain injury. Short-term neuroprotection (<1 week post-ischemia) in experimental cerebral ischemia has been reported in multiple works, although long-term neuroprotection (≥ 1 week post-ischemia) remains controversial. Comparison works have not demonstrated superiority of one specific volatile agent over another in experimental models of brain injury. Relatively few human works have examined the protective effects of volatile anesthetic agents and conclusive evidence of a neuroprotective effect has yet to emerge from human works. Conclusion: Proposed mechanisms related to the neuroprotective effect of volatile anesthetic agents include activation of ATP-dependent potassium channels, up-regulation of nitric oxide synthase, reduction of excitotoxic stressors and cerebral metabolic rate, augmentation of peri- ischemic cerebral blood flow and up-regulation of antiapoptotic factors including MAP kinases.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalNeurological Research
Volume31
Issue number2
DOIs
StatePublished - Mar 2009

Fingerprint

Neuroprotective Agents
Anesthetics
Brain Ischemia
Brain Injuries
Cerebrovascular Circulation
Up-Regulation
Ischemia
National Library of Medicine (U.S.)
Enflurane
Isoflurane
Potassium Channels
National Institutes of Health (U.S.)
Halothane
Nitric Oxide Synthase
Publications
Theoretical Models
Phosphotransferases
Adenosine Triphosphate
Databases
Neuroprotection

Keywords

  • Cerebral ischemia
  • Desflurane
  • Enflurane
  • Halothane
  • Isoflurane
  • Sevoflurane

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Neuroprotective effect of volatile anesthetic agents : Molecular mechanisms. / Matchett, Gerald A.; Allard, Martin W.; Martin, Robert D.; Zhang, John H.

In: Neurological Research, Vol. 31, No. 2, 03.2009, p. 128-134.

Research output: Contribution to journalArticle

Matchett, Gerald A. ; Allard, Martin W. ; Martin, Robert D. ; Zhang, John H. / Neuroprotective effect of volatile anesthetic agents : Molecular mechanisms. In: Neurological Research. 2009 ; Vol. 31, No. 2. pp. 128-134.
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