gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Propofol versus sevoflurane: action on glutamate and energetic metabolites measured by microdialysis in living human brain

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  • corresponding author G. Dran - Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice Sophia-Antipolis
  • E. Carré - Laboratoire de Neurochimie, Institut de Médecine Navale du Service de Santé des Armées, Toulon, France
  • G. Rezzadori - Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice Sophia-Antipolis
  • J.-J. Risso - Laboratoire de Neurochimie, Institut de Médecine Navale du Service de Santé des Armées, Toulon, France
  • P. Paquis - Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice Sophia-Antipolis
  • M. Lonjon - Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice Sophia-Antipolis

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP062

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0330.shtml

Published: May 4, 2005

© 2005 Dran et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Propofol is a neurosedative molecule more and more used in cranial trauma reanimation for a potential neuroprotective effect. This property was demonstrated in brain cells or animal experimentations. However, mechanisms of this neuroprotection remain uncertain. Several hypothesis are proposed and among them an action on brain glutamate level. Indeed, this neurotransmitter is a major excitotoxic when released in high quantities. The authors compared propofol and sevoflurane concerning their action on glutamate and energetic metabolites levels in human normal brain.

Methods

A randomised, prospective and comparative trial was realised on 20 consecutives patients admitted in our Neurosurgical Department. During maintenance phase of anaesthesia, propofol was used in the first group and sevoflurane was used in the second one. Brain microdialysis has been used to follow the changes of extra-cellular fluid composition. Microdialysis probes were introduced, during surgery, in normal brain and let in place during 24 hours. Microdialysis samples were then collected regularly and glutamate, glucose, lactate, and pyruvate concentrations were measured.

Results

Nine patients were finally included in propofol group and ten in sevoflurane group. Results were first stated in absolute value and a second time in relative value compare to a steady-state. Significant level variations were observed in each group, for a given molecule, between different phases of anaesthesia. Difference was not statistically significant between the two groups concerning all molecules analysed.

Conclusions

These findings suggest that propofol has not a preference share on brain suffering markers, compare to sevoflurane, in human normal brain.