Objective: To compare the effects of anesthesia with ketamine and ketamine-midazolam on focal cerebral ischemic injury in rats and evaluate the neuroprotective effect of ketamine-midazolam anesthesia during surgical procedures.
Methods: Thirty male Sprague-Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO) under anesthesia with intraperitoneal administration of ketamine alone or in combination with midazolam (n=15). Neurological scoring was conducted the infarct size measured at 4 h and 24 h after the surgery. Histological examination was performed using TUNEL staining 72 h after MCAO.
Results: After MCAO, the neurological scores showed no significant difference between ketamine and ketamine-midazolam groups (1.57+/-0.65 vs 1.74+/-0.52, P>0.05), but the rats in the latter group had significantly smaller infarct size (38.48/+/-4.18/ vs 24.1/+/-4.63/, P<0.05) and lower apoptotic cell density (258+/-15 cells/mm2 vs 178+/-23 cells/mm2, P<0.05) in the penumbra.
Conclusion: Compared with ketamine used alone, anesthesia with the combination of ketamine and midazolam may provide neuroprotection from ischemic cerebral injury by reducing the infarct size and lowering the cell apoptosis rate following MCAO in rats.