Anesthetics, cerebral protection and preconditioning

Braz J Anesthesiol. 2013 Jan;63(1):119-28. doi: 10.1016/j.bjane.2012.06.003. Epub 2013 Aug 7.

Abstract

Background and objectives: Several studies demonstrate that cerebral preconditioning is a protective mechanism against a stressful situation. Preconditioning determinants are described, as well as the neuroprotection provided by anesthetic and non-anesthetics agents.

Content: Review based on the main articles addressing the pathophysiology of ischemia-reperfusion and neuronal injury and pharmacological and non-pharmacological factors (inflammation, glycemia, and temperature) related to the change in response to ischemia-reperfusion, in addition to neuroprotection induced by anesthetic use.

Conclusions: The brain has the ability to protect itself against ischemia when stimulated. The elucidation of this mechanism enables the application of preconditioning inducing substances (some anesthetics), other drugs, and non-pharmacological measures, such as hypothermia, aimed at inducing tolerance to ischemic lesions.

Keywords: Anesthetics; Central Nervous System; Hypothermia.; Ischemia; Ischemic Preconditioning.

Publication types

  • Review

MeSH terms

  • Anesthetics / therapeutic use*
  • Brain Ischemia / prevention & control
  • Brain Ischemia / therapy
  • Humans
  • Ischemic Preconditioning / methods*
  • Neuroprotective Agents / therapeutic use*
  • Reperfusion Injury / prevention & control
  • Reperfusion Injury / therapy

Substances

  • Anesthetics
  • Neuroprotective Agents