Adverse effects on the brain in connection with isoflurane-induced hypotensive anaesthesia

As a marker of brain cell injury, adenylate kinase (AK) was measured in cerebrospinal fluid (CSF) in 10 patients given anaesthesia with isoflurane-induced hypotension for corrective surgery of dentofacial deformities. Nine out of 10 patients displayed a marked increase in CSF-AK postoperatively compared with preoperative values. The postoperative mean value displayed a 400% increase compared to the corresponding preoperative value. This difference was statistically significant (P = 0.001). The rise in CSF-AK was most probably the result of an enhanced efflux of AK into CSF subsequent to a presumed hypoxic injury to brain cells.