Effects of Anesthetic Agents and Other Drugs on Cerebral Blood Flow, Metabolism, and Intracranial Pressure

Sakabe, Takefumi; Matsumoto, Mishiya

doi:10.1016/b978-0-323-05908-4.10010-7

Cited by 25 publications

(26 citation statements)

References 192 publications

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“…Ketamine is an N-methyl-D-aspartate antagonist with proven neuroprotective effects both, in vivo (126,127), and in vitro (128)(129)(130). However, it is also a potent cerebral vasodilator producing increases in CBF, CBV, CMRO 2 and potentially ICP, and can not be recommended in patients with reduced intracranial compliance (74,(131)(132)(133).…”

Section: Intravenous Anesthetic Agentsmentioning

confidence: 99%

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Impact of anesthetic agents on cerebrovascular physiology in children

Szabó

Luginbuehl

Bissonnette

2009

Pediatric Anesthesia

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The role of the pediatric neuroanesthetist is to provide comprehensive care to children with neurologic pathologies. The cerebral physiology is influenced by the developmental stage of the child. The understanding of the effects of anesthetic agents on the physiology of cerebral vasculature in the pediatric population has significantly increased in the past decade allowing a more rationale decision making in anesthesia management. Although no single anesthetic technique can be recommended, sound knowledge of the principles of cerebral physiology and anesthetic neuropharmacology will facilitate the care of pediatric neurosurgical patients.

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Section: Intravenous Anesthetic Agentsmentioning

confidence: 99%

“…All potent volatile anesthetics are direct cerebral vasodilators. Halothane is widely regarded as the most potent (74). In children, halothane induced increases in CBF persist even after halothane concentrations have been decreased (75).…”

mentioning

confidence: 99%

Impact of anesthetic agents on cerebrovascular physiology in children

Szabó

Luginbuehl

Bissonnette

2009

Pediatric Anesthesia

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“…But in our study the mean propofol dose requirement was 71.26 ± 11.78 µg/ kg/min for maintenance of anesthesia supplemented with butorphanol and N 2 O in neurosurgeries. Due to its unfavorable effects on cerebral hemodynamics and cerebrospinal fluid dynamics [1] and tendency to cause postoperative nausea and vomiting (PONV) [25] N 2 O has a controversial role in current day neurosurgical anesthesiology. In our study the mean maintenance and overall dose of propofol without the use of N 2 O 90.82 ± 19.13 µg/kg/min and 100.02 ± 20.28 µg/kg/min respectively.…”

Section: Discussionmentioning

confidence: 99%

“…It causes a dose dependent decrease in intracranial pressure maintaining cerebral perfusion at modest doses. Furthermore it causes a reduction in cerebral metabolic rate (CMR) without any disturbance in cerebral reactivity to carbon dioxide and autoregulation [1]. Nitrous oxide (N 2 O) is less preferred anesthetic agent in current neurosurgical anesthesiology practice due to its unfavorable effects on neurophysiology.…”

Section: Introductionmentioning

confidence: 99%

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Propofol Requirement during Propofol and Butorphanol Anesthesia with and without Nitrous Oxide in Short Duration Intracranial Surgeries: A Bispectral Index Guided Study

Dube¹,

Dubey²,

Mishra³

2012

J Anesthe Clinic Res

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Atypical Developmental Patterns of Brain Chemistry in Children With Autism Spectrum Disorder

et al. 2013

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IMPORTANCE Autism spectrum disorder (ASD) is a neurodevelopmental disorder with symptoms emerging during early childhood. The pathophysiology underlying the disorder remains incompletely understood. OBJECTIVE To examine cross-sectional and longitudinal patterns of brain chemical concentrations in children with ASD or idiopathic developmental delay (DD) from 3 different age points, beginning early in the clinical course. DESIGN Proton magnetic resonance spectroscopic imaging data were acquired longitudinally for children with ASD or DD, and primarily cross-sectionally for children with typical development (TD), at 3 to 4, 6 to 7, and 9 to 10 years of age. SETTING Recruitment, diagnostic assessments, and magnetic resonance imaging were performed at the University of Washington in Seattle. PARTICIPANTS Seventy-three children (45 with ASD, 14 with DD, and 14 with TD) at 3 to 4 years of age; 69 children (35 with ASD, 14 with DD, and 20 with TD) at 6 to 7 years of age; and 77 children (29 with ASD, 15 with DD, and 33 with TD) at 9 to 10 years of age. MAIN OUTCOMES AND MEASURES Concentrations of N-acetylaspartate (NAA), choline (Cho), creatine (Cr), myo-inositol (mI), and glutamine plus glutamate (Glx) in cerebral gray matter (GM) and white matter (WM) at 3 to 4, 6 to 7, and 9 to 10 years of age, and calculation of rates of change of these chemicals between 3 and 10 years of age. RESULTS At 3 to 4 years of age, the ASD group exhibited lower NAA, Cho, and Cr concentrations than did the TD group in both GM and WM, alterations that largely were not observed at 9 to 10 years of age. The DD group exhibited reduced GM and WM NAA concentrations at 3 to 4 years of age; GM NAA concentrations remained reduced at 9 to 10 years of age compared with the TD group. There were distinct differences between the ASD and DD groups in the rates of GM NAA, Cho, and Cr changes between 3 and 10 years of age. CONCLUSIONS AND RELEVANCE The GM chemical changes between 3 and 10 years of age differentiated the children with ASD from those with DD. Most notably, a dynamic reversal of GM NAA reductions was observed in the children with ASD. By contrast, persistent GM NAA reductions in the children with DD suggest a different, more static, underlying developmental process.

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Effects of Anesthetic Agents and Other Drugs on Cerebral Blood Flow, Metabolism, and Intracranial Pressure

Cited by 25 publications

References 192 publications

Impact of anesthetic agents on cerebrovascular physiology in children

Impact of anesthetic agents on cerebrovascular physiology in children

Propofol Requirement during Propofol and Butorphanol Anesthesia with and without Nitrous Oxide in Short Duration Intracranial Surgeries: A Bispectral Index Guided Study

Atypical Developmental Patterns of Brain Chemistry in Children With Autism Spectrum Disorder

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