Journal article
Effect of General Anesthetics on Caspase-3 Levels in Patients With Aneurysmal Subarachnoid Hemorrhage: A Preliminary Study
Journal of neurosurgical anesthesiology, Vol.33(2), pp.172-176
04/01/2021
DOI: 10.1097/ANA.0000000000000648
PMID: 31599811
Abstract
General anesthesia has been associated with neuronal apoptosis and activation of caspases. Apoptosis is a crucial factor in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). We conducted a double-blind, prospective, randomized pilot study to evaluate the effect of 4 anesthetic agents on cerebrospinal fluid (CSF) and serum caspase-3 levels in aSAH patients.
A total of 44 good-grade aSAH patients with preoperative lumbar drain scheduled for surgical clipping or endovascular coiling were randomized to receive maintenance of anesthesia with propofol, isoflurane, sevoflurane, or desflurane. Caspase-3 levels were measured in CSF and serum samples collected at baseline, 1 hour after induction, and 1 hour after cessation of anesthesia.
Compared with baseline, there was a decrease in CSF caspase-3 levels and an increase in serum caspase-3 levels 1 hour after exposure to all 4 anesthetic agents; levels returned to baseline values after cessation of anesthesia. Median CSF caspase-3 levels at baseline, 1 hour after anesthesia exposure, and 1 hour after cessation of anesthesia were 0.0679, 0.0004, and 0.0689 ng/mL, respectively (P<0.05). Median serum caspase-3 levels at baseline, 1 hour after anesthesia exposure, and 1-hour after cessation of anesthesia were 0.0028, 0.0682, and 0.0044 ng/mL, respectively (P<0.05).
Propofol, isoflurane, sevoflurane, or desflurane have similar effects on CSF and serum caspase-3. The reduction of intraoperative CSF caspase-3 levels suggests a possible role for general anesthesia in neuroresuscitation by slowing the neuronal apoptotic pathway.
Details
- Title: Subtitle
- Effect of General Anesthetics on Caspase-3 Levels in Patients With Aneurysmal Subarachnoid Hemorrhage: A Preliminary Study
- Creators
- Mukilan Balasubramanian - Department of Anaesthesia and Intensive Care, Division of NeuroanesthesiaAswini Kuberan - Jawaharlal Institute of Post Graduate Medical Education and ResearchAmit Rawat - Division of Pediatric Immunology and AllergySivashanmugam Dhandapani - Department of NeurosurgeryNidhi Panda - Department of Anaesthesia and Intensive Care, Division of NeuroanesthesiaAjay Kumar - Post Graduate Institute of Medical Education and ResearchAsish K Sahoo - Department of Anaesthesia and Intensive Care, Division of NeuroanesthesiaMunish Kumar - Department of Anaesthesia and Intensive Care, Division of NeuroanesthesiaTanavi Sharma - Department of Anaesthesia and Intensive Care, Division of NeuroanesthesiaPaul S Garcia - New York Hospital QueensHemant Bhagat - Department of Anaesthesia and Intensive Care, Division of Neuroanesthesia
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgical anesthesiology, Vol.33(2), pp.172-176
- DOI
- 10.1097/ANA.0000000000000648
- PMID
- 31599811
- NLM abbreviation
- J Neurosurg Anesthesiol
- ISSN
- 0898-4921
- eISSN
- 1537-1921
- Language
- English
- Date published
- 04/01/2021
- Academic Unit
- Anesthesia
- Record Identifier
- 9984845251402771
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