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Propofol attenuates the neuroprotective effects of magnesium in experimental traumatic brain injury

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Objectives

Propofol is a popular nonbarbiturate anesthetic agent. Its neuroprotective effects are controversial. The neuroprotective effects of magnesium salts have been documented. We aimed to examine the neuroprotective effects of propofol alone and with magnesium on brain edema and blood-brain barrier (BBB) breakdown after experimental traumatic brain injury (TBI) in rats.

Method

Experimental closed head trauma was induced on Sprague-Dawley rats by allowing 450-g weight falling from a 2-m height onto a metallic disc fixed to the intact skull. Rats were assigned into four groups to receive intraperitoneally 1 ml/kg saline in the control group (C, n = 10), 10 mg/kg propofol in the propofol group (P, n = 10), 750 μmol/kg magnesium sulphate (MgSO4) in the magnesium group (M, n = 10), 10 mg/kg propofol and 750 μmol/kg MgSO4 in the magnesium-propofol group (PM, n = 10) 30 min after TBI. Brain water content (BWC) and specific gravity (SG), as indicators of brain edema were measured 24 hours after TBI. BBB breakdown was evaluated quantitatively 24 hours after TBI by fluorometric assay of Evans blue dye (EBD) extravasations.

Results

The increase in BWC, the reduction in SG and EBD content in the group P was statistically significant when compared to the group C. In the group PM, BWC was significantly higher and SG was significantly lower than group M. EBD content in the brain tissue was also significantly increased in the group PM when compared to group M (Table 1).

Table 1 Statistical significance (P) comparison of BWC, SG, and EBD content between the groups

Conclusions

These experimental data have shown that although propofol has neuroprotective effects on TBI, it is not as effective as magnesium, and it attenuates the neuroprotective effects of magnesium sulphate on secondary injury factors following traumatic brain injury.

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Aktan, D., Erden, T., Kaya, M. et al. Propofol attenuates the neuroprotective effects of magnesium in experimental traumatic brain injury. Crit Care 6, P65 (2002). https://doi.org/10.1186/cc1767

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Keywords

  • Traumatic Brain Injury
  • Neuroprotective Effect
  • Specific Gravity
  • Brain Edema
  • Evans Blue