Anesthetics and brain protection

Head, Brian P.; Patel, Piyush M.

doi:10.1097/aco.0b013e3282efa69d

Cited by 59 publications

(35 citation statements)

References 52 publications

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“…Most intravenous and inhalational anesthetic agents have demonstrated neuroprotective effects in animal models of focal and global brain ischemia, yet these effects have not translated into clinical trials in traumatic brain injury, aneurysm surgery, or acute stroke. 35 Most recently, a posthoc analysis of the Intraoperative Hypothermia for Aneurysm Surgery (IHAST) study data failed to demonstrate an improvement in neurologic outcomes with supplemental protective drug. 36 While a detailed review of the literature on anesthetic neuroprotection is beyond the scope of this article, several recent review papers summarize the topic nicely.…”

Section: Anesthetic Neuroprotectionmentioning

confidence: 98%

Anesthetic Management of Patients with Acute Stroke

Flexman

Donovan

Gelb

2012

Anesthesiology Clinics

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Section: Anesthetic Neuroprotectionmentioning

confidence: 98%

Anesthetic Management of Patients with Acute Stroke

Flexman

Donovan

Gelb

2012

Anesthesiology Clinics

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“…Propofol und volatile Anästhetika sind in tierexperimentellen Studien neuropro tektiv, können jedoch nur milde oder mä ßige ischämische neuronale Schädigungen reduzieren [28]. Der Wirkmechanismus scheint dabei weniger die Reduktion der zerebralen Metabolisierungsrate von Sau erstoff zu sein, sondern die positive Mo dulation pathophysiologischer Kaskaden, die erst durch die Ischämie in Gang ge setzt werden [2, 17,18,34].…”

Section: Pharmakologische Neuroprotektionunclassified

Neuromonitoring und Neuroprotektion in der Kardioanästhesie

Erdös

Tzanova²,

Schirmer³

et al. 2009

Anaesthesist

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“…Sevoflurane is a widely used clinical inhalation anesthesic. Increasing evidences have proved that sevoflurane preconditioning could protect against multiple organ injury, such as lung, liver, and brain (11,12). Emulsified sevoflurane has been synthetized that comprise emulsification of sevoflurane into a lipid vehicle and simplifies its intravenous application in clinic.…”

Section: January 2017mentioning

confidence: 99%

Effects of Emulsified Sevoflurane and Ulinastatin on Liver and Lung Injury Induced by Bile Duct Ligation in Rats

Chen¹,

Zhu²,

Wang³

et al. 2017

J Anesth Perioper Med

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Backgroud: To investigate the effects and their mechanisms of emulsified sevoflurane and ulinastatin on liver and lung injury induced by obstructive jaundice in rats. Methods: For the in vivo study, male Sprague-Dawley rats were randomized into two parts. Part 1: Sham group, bile duct ligation (BDL) group, BDL and lipid vehicle infusion (BDL + V) group, BDL + ulinastatin (BDL + U) group, BDL + emulsified sevoflurane (BDL + E) group; Liver and lung function was examined by the concentrations of Total Bilirubin (TBIL), Alanine Transaminase (ALT), and lung arterial blood gas analysis. Liver and lung damage was estimated histologically with haematoxylin and eosin (HE) staining in liver and lung samples. F4/80, the molecular marker of activated macrophages, was assessed by immunohistochemistry (IHC). Part 2: Sham + Gadolinium chloride (GdCl3)group, BDL+GdCl3 group, BDL+U+GdCl3 group, BDL+E+ GdCl3 group. After the deletion of macrophages, liver and lung examinations were evaluated histologically with HE staining in GdCl3 treated rats. For the in vitro study, the RAW264.7 cell line was stimulated by the different treatments, then terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL staining), Hoechst 33342 staining and the expressions of apoptotic related genes were evaluated to further determine the protective effects of ulinastatin and emulsified sevoflurane. Results: Emulsified sevoflurane and ulinastatin therapies alleviated cholestatic liver and lung damage, inhibited the activation of macrophages in the liver and lung tissues, and improved the liver and lung functions. And they were also found to inhibit apoptosis pathways. Conclusions: Emulsified sevoflurane and ulinastatin treatments were proved to ameliorate BDL-induced cholestatic liver and lung injuries, which were related to the inactivation of the macrophages and the regulation of apoptosis pathways. The abovementioned mechanisms show new promising approach for the multi-organs injuries in the perioperative management.

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Anesthetics and brain protection

Abstract: The available data indicate that anesthetics can provide long-term durable protection against ischemic injury that is mild to moderate in severity. Experimental data do not provide support for the premise that anesthetics reduce injury when the ischemic injury is severe.

Cited by 59 publications

References 52 publications

Anesthetic Management of Patients with Acute Stroke

Anesthetic Management of Patients with Acute Stroke

Neuromonitoring und Neuroprotektion in der Kardioanästhesie

Effects of Emulsified Sevoflurane and Ulinastatin on Liver and Lung Injury Induced by Bile Duct Ligation in Rats

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