Neuroprotection provided by isoflurane pre-conditioning and post-conditioning

Abstract

Isoflurane, a volatile and inhalational anesthetic, has been extensively used in perioperative period for several decades. A large amount of experimental studies have indicated that isoflurane exhibits neuroprotective properties when it is administrated before or after (pre-conditioning and post-conditioning) neurodegenerative diseases (e.g., hypoxic ischemia, stroke and trauma). Multiple mechanisms are involved in isoflurane induced neuroprotection, including activation of glycine and γ-aminobutyric acid receptors, antagonism of ionic channels and alteration of the function and activity of other cellular proteins. Although neuroprotection provided by isoflurane is observed in many animal studies, convincing evidence is lacking in human trials. Therefore, there is still a long way to go before translating its neuroprotective properties into clinical practice.

Role of spinal GABA receptors in the acute antinociceptive response of mice to hyperbaric oxygen

“…Isoflurane administration during i.t. procedures can complicate the interpretation of our results since isoflurane has been shown to have both neuroprotective and neurotoxic affects (Jiang et al, 2017). Isoflurane pretreatment has been implicated as having protective effects in ischemia in animal models (Jiang et al, 2017).…”

“…procedures can complicate the interpretation of our results since isoflurane has been shown to have both neuroprotective and neurotoxic affects (Jiang et al, 2017). Isoflurane pretreatment has been implicated as having protective effects in ischemia in animal models (Jiang et al, 2017). In animal models of neural injury in neonatal rats, isoflurane was shown to decrease the hypoxia-related increase in the release of amino acid neurotransmitters while elevating levels of GABA (Zhao et al, 2016).…”

Structural and Functional Remodeling of the Brain Vasculature Following Stroke

“…In addition, the choice of anesthetic regimen is crucial when performing stroke surgery in rodents, as it can strongly influence CBF and stroke outcome, and may contribute to translational failure ( O’Collins et al, 2006 ). For instance, isoflurane is a potent vasodilator with neuroprotective effects ( Tsuda, 2010 ; Gaidhani et al, 2017 ; Jiang et al, 2017 ; Lu et al, 2017 ) via modulation of eNOS activity ( Kehl et al, 2002 ; Krolikowski et al, 2006 ), which strongly confounds results. Ketamine/Xylazine (K/X) anesthesia affects baseline CBF to a lesser extent, but has also been shown to modulate eNOS ( Chen et al, 2005 ).…”

Isoflurane reduces septic neuron injury by HO‑1‑mediated abatement of inflammation and apoptosis

“…A previous study reported that the use of ISO during surgery is considered optimal for neuroprotection ( 47 ). ISO post-conditioning notably decreases the infarct volume and improves the neurobehavioral performance of rats subjected to middle cerebral artery occlusion, thereby providing increased ischemic tolerance in the brain ( 48 ).…”