The neuroprotective effect of combining sevoflurane and remote ischemic preconditioning in forebrain ischemia model

ABSTRACT

BACKGROUND: The aim of this study was to investigate the combining effects of sevoflurane and remote ischemic preconditioning (RIPC) on cell death of pyramidal neurons in the CA1 hippocampus induced by transient global cerebral ischemia in rats. METHODS: Twenty rats were assigned to one of two groups; sevoflurane group and combination of sevoflurane and RIPC group. RIPC was performed by occluding the bilateral femoral arteries for 10 min 3 times in an interval of 10 min. Ischemia was induced by a bilateral common carotid artery occlusion plus hemorrhagic hypotension (26-30 mmHg) and was maintained for 8 min. Histologic outcomes were measured at 7 days after ischemia in CA1 pyramidal cells of the rat hippocampus. RESULTS: The combination group contained significantly more viable cells in the hippocampal CA1 area than sevoflurane group (71% vs. 46%, P = 0.03). The mean percentage of apoptotic cells was significantly reduced in the combination group compared to sevoflurane group (11% vs. 41%, P = 0.014). CONCLUSIONS: A combination of sevoflurane and RIPC can offer additional neuroprotective effects after transient global cerebral ischemia in rats.