Comparison of neuroprotective effect of isoflurane and sevoflurane on cerebral ischemia

Abstract

Objectives: In this study, we aimed to evaluate the effects of isoflurane and sevoflurane on cerebral ischemiain patients undergoing intracranial tumour surgery by measuring protein S-100B in serum. Patients undergoingintracranial surgery are at risk for cerebral ischemia. The presence of S100-B in serum is an early and the mostsensitive determinant of cerebral ischemia.Methods: Twenty patients, scheduled for elective, intracranial tumor surgery were enrolled in this prospectiveand randomized study. Anaesthesia induction was performed with thiopental, fentanyl and vecuronium. In themaintenance, isoflurane or sevoflurane was administered in a minimum alveolar concentration of 0.8-1.2%.Peripheral blood samples were taken at 9 different times to measure protein S-100B levels.Results: Demographic data, heart rate, systolic arterial pressure, mean arterial pressure and the deviations inthe end-tidal carbon dioxide were similar in the study groups (p > 0.05), whereas diastolic arterial pressurewas found to be significantly decreased in isoflurane group after the intubation, and there was an increase inthe sevoflurane group (p < 0.05). Also there was no significant difference between the groups regarding proteinS-100B levels.Conclusions: It was concluded that isoflurane and sevoflurane have similar neuroprotective effects againstcerebral ischemia and sevoflurane may be a good alternative to isoflurane.