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Isoflurane doubles plasma glutamate and increases posttraumatic brain edema.
J F Stover1, S N Kroppenstedt, U W Thomale
1Institute for Neurosurgical Pathophysiology, Mainz, Germany.
Acta Neurochirurgica. Supplement
|July 14, 2001
Summary
Prolonged isoflurane anesthesia significantly elevates glutamate levels and brain water content in rats after brain injury. This finding is crucial for managing patients undergoing extended isoflurane anesthesia.
Area of Science:
- Neuroscience
- Anesthesiology
- Pathophysiology
Background:
- Elevated glutamate levels and cerebral edema are linked to brain injury.
- Volatile anesthetics can increase plasma amino acid concentrations.
Purpose of the Study:
- To investigate the effect of isoflurane on plasma glutamate levels and brain edema in brain-injured rats.
- To compare isoflurane's effects with chloral hydrate anesthesia.
Main Methods:
- Controlled cortical impact injury was induced in rats.
- Anesthesia was administered using chloral hydrate or isoflurane for four hours.
- Arterial plasma glutamate levels and brain water content were measured.
Main Results:
- Isoflurane significantly increased arterial glutamate levels compared to chloral hydrate (124 +/- 12 vs. 60 +/- 5 microM).
- Brain water content was significantly increased in both hemispheres after isoflurane anesthesia compared to chloral hydrate (80.1 +/- 0.1 vs. 79.6 +/- 0.1%).
- Brain edema formation was evident eight hours after trauma.
Conclusions:
- Prolonged isoflurane anesthesia is associated with increased plasma glutamate and brain water content.
- The potential for increased brain edema should be considered during prolonged isoflurane administration.