Cerebral autoregulation and anesthesia

被引：97

作者：

Dagal, Armagan ^{[1
]}

Lam, Arthur M. ^{[1
]}

机构：

[1] Univ Washington, Harborview Med Ctr, Dept Anesthesiol, Seattle, WA 98104 USA

来源：

CURRENT OPINION IN ANESTHESIOLOGY | 2009年 / 22卷 / 05期

关键词：

anesthetics; cerebral autoregulation; cerebral blood flow; cerebral blood flow velocity; cerebral perfusion pressure; transcranial Doppler; CEREBROVASCULAR PRESSURE-REACTIVITY; TOTAL INTRAVENOUS ANESTHESIA; BLOOD-FLOW-VELOCITY; TRANSCRANIAL DOPPLER; INTRACRANIAL-PRESSURE; PERFUSION-PRESSURE; OXYGEN-CONSUMPTION; HYPEREMIC RESPONSE; NITROUS-OXIDE; LOWER LIMIT;

D O I：

10.1097/ACO.0b013e32833020be

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Purpose of review This review will examine the recent literature on anesthesia and monitoring techniques in relation to cerebral autoregulation. We will discuss the effect of physiologic and pharmacological factors on cerebral autoregulation alongside its clinical relevance with the help of new evidence. Recent findings Intravenous anesthesia, such as combination of propofol and remifentanil, provides best preservation of autoregulation. Among inhaled agents sevoflurane appears to preserve autoregulation at all doses, whereas with other agents autoregulation is impaired in a dose-related manner. Summary Intraoperative cerebral autoregulation monitoring is an important consideration for the patients with neurologic disease. Transcranial Doppler based static autoregulation measurements appears to be the most robust bedside method for this purpose.

引用

页码：547 / 552

页数：6

共 60 条

[51] Cerebrovascular pressure reactivity is related to global cerebral oxygen metabolism after head injury [J].

Steiner, LA ;

Coles, JP ;

Czosnyka, M ;

Minhas, PS ;

Fryer, TD ;

Aigbirhio, FI ;

Clark, JC ;

Smielewski, P ;

Chatfield, DA ;

Donovan, T ;

Pickard, JD ;

Menon, DK .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2003, 74 (06) :765-770

[52] Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury [J].

Steiner, LA ;

Czosnyka, M ;

Piechnik, SK ;

Smielewski, P ;

Chatfield, D ;

Menon, DK ;

Pickard, JD .

CRITICAL CARE MEDICINE, 2002, 30 (04) :733-738

[53] Near-Infrared Spectroscopy can Monitor Dynamic Cerebral Autoregulation in Adults [J].

Steiner, Luzius A. ;

Pfister, David ;

Strebel, Stephan P. ;

Radolovich, Danila ;

Smielewski, Peter ;

Czosnyka, Marek .

NEUROCRITICAL CARE, 2009, 10 (01) :122-128

[54] REGULATION OF CEREBRAL BLOOD-FLOW IN HEALTH AND DISEASE [J].

STRANDGAARD, S ;

PAULSON, OB .

JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 1992, 19 :S89-S93

[55] DYNAMIC AND STATIC CEREBRAL AUTOREGULATION DURING ISOFLURANE, DESFLURANE, AND PROPOFOL ANESTHESIA [J].

STREBEL, S ;

LAM, AM ;

MATTA, B ;

MAYBERG, TS ;

AASLID, R ;

NEWELL, DW .

ANESTHESIOLOGY, 1995, 83 (01) :66-76

[56] Dynamic cerebral autoregulation during sevoflurane anesthesia: A comparison with isoflurane [J].

Summors, AC ;

Gupta, AK ;

Matta, BF .

ANESTHESIA AND ANALGESIA, 1999, 88 (02) :341-345

[57] COMPARISON OF STATIC AND DYNAMIC CEREBRAL AUTOREGULATION MEASUREMENTS [J].

TIECKS, FP ;

LAM, AM ;

AASLID, R ;

NEWELL, DW .

STROKE, 1995, 26 (06) :1014-1019

[58]

Todd M M, 1994, Adv Pharmacol, V31, P595, DOI 10.1016/S1054-3589(08)60644-4

[59] Dynamic cerebral autoregulation in healthy adolescents [J].

Vavilala, MS ;

Newell, DW ;

Junger, E ;

Douville, CM ;

Aaslid, R ;

Rivara, FP ;

Lam, AM .

ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2002, 46 (04) :393-397

[60] Cerebral autoregulation before and after blood transfusion in a child [J].

Vavilala, MS ;

Lee, LA ;

Morris, GP ;

Lam, AM .

JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2001, 13 (03) :233-236

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