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PEDIATRIC ANESTHESIA

Isoflurane-Induced Neuronal Degeneration: An Evaluation in Organotypic Hippocampal Slice Cultures

Lisa Wise-Faberowski, MD^*, Haito Zhang, PhD, Richard Ing, MB, BCh, FCA (SA)^*, Robert D. Pearlstein, PhD, and David S. Warner, MD^*

Departments of *Anesthesiology, Neurobiology, and Surgery, Duke University Medical Center, Durham, North Carolina; and Department of Neurobiology, Loma Linda University, Loma Linda, California

Address correspondence and reprint requests to Lisa Wise-Faberowski, MD, Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC. Address e-mail to faber007{at}mc.duke.edu.

Prolonged exposure of postnatal day (PND) 7 rat pups to anesthetics, which act via N-methyl-d-aspartate antagonism and/or -amino butyric acid enhancement, causes neurodegeneration and persistent behavioral deficits. We studied these findings in vitro and determined whether the age of rat pups used for study or duration of anesthetic exposure modulates resultant neurodegeneration. Organotypic hippocampal slices (OHSs) were prepared from rat pups on PNDs 4, 7, and 14 and cultured 7 or 14 days in vitro. The slices were exposed to 1.5% isoflurane or fresh gas for durations of 1, 3, or 5 h. Hippocampal CA1, CA3, and dentate gyrus neuronal survival was assessed 3 days later. Neuronal cell death was greatest in OHSs prepared from PND 7 rat pups (P < 0.001) and was most evident after 5 h exposure to isoflurane (P < 0.001). By eliminating variables such as hemodynamics, nutrition, oxygenation, and carbon dioxide elimination, this in vitro investigation supports both an age- and duration-dependent relationship between 1.5% isoflurane exposure and perinatal neuronal death.

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