Neuroprotective effects of propofol, thiopental, etomidate, and midazolam in fetal rat brain in ischemia-reperfusion model

• Published in: Child's nervous system Vol. 28; no. 7; pp. 1055 - 1062
• Main Authors: Harman, Ferhat, Hasturk, Askin Esen, Yaman, Mehmet, Arca, Turkan, Kilinc, Kamer, Sargon, Mustafa Fevzi, Kaptanoglu, Erkan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-07-2012
• Subjects: Animals; Disease Models, Animal; Embryo, Mammalian; Etomidate - therapeutic use; Female; Lipid Peroxidation - drug effects; Male; Medicine; Medicine & Public Health; Microscopy, Electron, Transmission; Midazolam - therapeutic use; Neurons - pathology; Neurons - ultrastructure; Neuroprotective Agents - therapeutic use; Neurosciences; Neurosurgery; Original Paper; Pregnancy; Propofol - therapeutic use; Rats; Rats, Sprague-Dawley; Reperfusion Injury - pathology; Reperfusion Injury - prevention & control; Statistics, Nonparametric; Thiobarbituric Acid Reactive Substances - metabolism; Thiopental - therapeutic use; Time Factors; Ischemia-reperfusion; Neuroprotection; Rat; Thiopental; Propofol; Midazolam; Etomidate
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-012-1782-0

Purpose
The aim of this study was to investigate the neuroprotective effects of propofol, thiopental, etomidate, and midazolam as anesthetic drugs in fetal rat brain in the ischemia-reperfusion (IR) model.
Methods
Pregnant rats of day 19 were randomly allocated into eight groups. Fetal brain ischemia was induced by clamping the utero-ovarian artery bilaterally for 30 min and reperfusion was achieved by removing the clamps for 60 min. In the control group, fetal rat brains were obtained immediately after laparotomy. In the sham group, fetal rat brains were obtained 90 min after laparotomy. In the IR group, IR procedure was performed. No treatment was given in the IR group. One milliliter intralipid solution, 40 mg/kg propofol, 3 mg/kg thiopental, 0.1 mg/kg etomidate, and 3 mg/kg midazolam was administered intraperitoneally in the vehicle group, propofol group, thiopental group, etomidate group, and midazolam group, respectively, 20 min before IR procedure. At the end of the reperfusion period, the whole brains of the fetal rats were removed for evaluation of thiobarbituric acid reactive substances and for examination by electron microscopy.
Results
According to lipid peroxidation data, all the anesthetic drugs provide neuroprotection; however, ultrastructural findings and mitochondrial scoring confirms that only propofol and midazolam provides a strong neuroprotective effect.
Conclusions
Propofol and midazolam may be used to protect fetal brain in case of acute fetal distress and hypoxic injury as a first choice anesthetic drug in cesarean delivery.