• Serge C Thal, Ralph Timaru-Kast, Florian Wilde, Philipp Merk, Frederik Johnson, Katrin Frauenknecht, Anne Sebastiani, Clemens Sommer, Irina Staib-Lasarzik, Christian Werner, and Kristin Engelhard.
• 1Department of Anesthesiology, Medical Center of Johannes Gutenberg University, Mainz, Germany. 2Department of Neuropathology, Medical Center of Johannes Gutenberg University, Mainz, Germany.
• Crit. Care Med. 2014 Jan 1; 42 (1): 129-41.

ObjectiveLimited data are available on the influence of sedation for critical care therapy with the widely used anesthetic propofol on recovery from acute traumatic brain injury. To establish the influence of propofol on endogenous neurogenesis and functional recovery after traumatic brain injury, rats were sedated with propofol either during or 2 hours after experimental traumatic brain injury.DesignRandomized controlled animal study.SettingUniversity research laboratory.SubjectsOne hundred sixteen male Sprague Dawley rats.InterventionsMechanical brain lesion by controlled cortical impact.Measurements And Main ResultsThis study investigated the dose-dependent influence of propofol (36 or 72 mg/kg/hr) either during controlled cortical impact induction or in a delayed application protocol 2 hours after experimental traumatic brain injury. Infusion of propofol resulted in 1) aggravation of neurologic dysfunction, 2) increased 28-day mortality rate, and 3) impaired posttraumatic neurogenesis (5-bromo-2-deoxyuridine + NeuN-positive cells). Application of propofol during trauma induction afforded a significant stronger effect in the high-dose group compared with low-dose propofol. In the posttrauma protocol, animals were sedated with sevoflurane during the controlled cortical impact injury, and propofol was given after an awake phase. In these animals, propofol increased mortality rate and impaired neurologic function and neurogenesis compared with animals without delayed propofol anesthesia.ConclusionsThe results show that propofol may prevent or limit reparative processes in the early-phase postinjury. The results therefore indicate that anesthetics may be potentially harmful not only in very young mammalians but also in adult animals following acute cerebral injuries. The results provide first evidence for an altered sensitivity for anesthesia-related negative effects on neurogenesis, functional outcome, and survival in adult rats with brain lesions.

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