Article Text

Isoflurane Provides Neuroprotection in Neonatal Hypoxic Ischemic Brain Injury
  1. Sherrefa R. Burchell, BS*,
  2. Brandon J. Dixon, BS*,
  3. Jiping Tang, MD*,
  4. John H. Zhang, MD, PhD*†
  1. From the Departments of *Physiology and Pharmacology and †Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA.
  1. Received May 6, 2012, and in revised form February 26, 2013.
  2. Accepted for publication February 28, 2013.
  3. Reprints: John H. Zhang, MD, PhD, Department of Neurosurgery, Loma Linda University School of Medicine, Risley Hall, Room 223, Loma Linda, CA 92354. E-mail: johnzhang3910{at}
  4. This symposium was supported in part by a grant from the National Center for Research Resources (R13 RR023236).


Isoflurane is a volatile anesthetic that is widely used clinically as an inhalational anesthetic. In recent years, several studies have indicated that isoflurane has neuroprotective properties. This has led to the beneficial effects of isoflurane being analyzed in both cell culture and animal models, including various models of brain injury. Neonatal hypoxia ischemia may be characterized as injury that occurs in the immature brain, resulting in delayed cell death via excitotoxicity and oxidative stress. These adverse events in the developing brain often lead to detrimental neurological defects in the future. Currently, there are no well-established effective therapies for neonatal hypoxia ischemia. In line with this, isoflurane, which displays neuroprotective properties in several paradigms and has been shown to improve neurological deficits caused by brain injuries, has the capability to be an extremely relevant clinical therapy for the resolution of deficits concomitant with neonatal hypoxic ischemic brain injuries. This review therefore seeks to explore and analyze the current information on isoflurane, looking at general isoflurane anesthetic properties, and the protection it confers in different animal models, focusing particularly on neuroprotection as shown in studies with neonatal hypoxic ischemic brain injury.

Key Words
  • isoflurane
  • long-term neuroprotection
  • preconditioning
  • postconditioning
  • isoflurane mechanism
  • neonatal hypoxia ischemia

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