Turkish Neurosurgery
Subarachnoid Hemorrhage and Sevoflurane
Mehmet Sorar1, Orhan Altay2
1SBU Ankara Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Beyin cerrahi, Altindag,
2SBU Ankara Numune Egitim ve Arastirma Hastanesi, Beyin cerrahi, Altindag,
DOI: 10.5137/1019-5149.JTN.24788-18.1

Aim:Sevoflurane, a volatile anesthetic agent, has been recognized for its potential neuroprotective properties. We aimed to examine whether post-treatment sevoflurane is protective against early brain injury (EBI) after subarachnoid hemorrhage (SAH) and how this neuroprotective effect occurs at different concentrations and durations of administration in mice. Furthermore, we tested whether the neuroprotective effect of post-treatment sevoflurane is associated with inhibition of apoptosis. Material and Methods:SAH was induced in mice by endovascular perforation. Animals were randomly assigned to five groups in each study. Study 1, sham-operated; SAH+vehicle-air; and SAH+1.5% sevoflurane for 30, 60, and 90 min. Study 2, SAH+3% sevoflurane for 30, 60, and 90 min. Study 3, SAH+4.5% sevoflurane for 30, 60, and 90 min. Neurobehavioral function and brain edema (brain water content) were evaluated 24 h after SAH. Neuroglial cell death was examined by terminal deoxynucleotidyl transferase-mediated uridine 5′-triphosphate-biotin nick end-labeling (TUNEL) staining.Results:Administration of 1.5% sevoflurane for 60 min and 3% sevoflurane for 30 and 60 min significantly improved neurobehavioral function, brain edema, and attenuated neuronal cell death in the basal cortex at 24 h after SAH.Conclusion:Administration of 1.5% sevoflurane for 60 min and 3% for 30 and 60 min sevoflurane application attenuated the development of EBI after SAH, implying its use for anesthesia during acute aneurysm surgery or intervention.

Corresponding author : Orhan Altay