Exposure to emulsified isoflurane and sevoflurane protects canine primary hepatocytes against hypoxia-induced apoptosis.

Objective: Emulsified isoflurane and sevoflurane have immunomodulating and anti-inflammatory effects in vital organs such as the brain, myocardium, and kidneys subjected to ischemia-reperfusion injury. This study aims to investigate the cellular protective effects of both emulsified anesthetics in cultured canine hepatocytes.

Procedures: We analyzed the apoptosis and viability responses of cultured primary canine hepatocytes exposed to 1% O2 for 30 versus 120 minutes after being treated with emulsified isoflurane or sevoflurane in 10% lipid, or 10% lipid alone or no-treatment control at 24 hours of reoxygenation (21% O2).

Results: After 120 minutes of hypoxia, the hepatocytes that received either emulsified isoflurane or sevoflurane treatments had significantly decreased apoptosis at 24 hours of reoxygenation in comparison to the 10% lipid treatment. Also, the no-treatment control group had significantly higher apoptosis at 24 hours of reoxygenation when exposed to 120 minutes of hypoxia compared to 30 minutes of hypoxia. Neither 30 nor 120 minutes of hypoxia or exposure to 10% lipid, emulsified isoflurane, or emulsified sevoflurane altered overall cellular viability at 24 hours of reoxygenation.

Clinical Relevance: This study demonstrated that both isoflurane and sevoflurane, in the emulsified form, have the potential to reduce the apoptotic response of cells under oxygen deprivation. Therefore, this attribute of both halogenated anesthetics suggests an alternative treatment to be applied in live patients submitted to surgical stabilization of organs and tissues under the risk of ischemia and reperfusion injury.