Hou Yuhui, Ye Wei, Tang Ziyuan, Li Fengxian
Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
Key Laboratory of Mental Health of the Ministry of Education, Guangdong Province Key Laboratory of Psychiatric Disorders, Southern Medical University, Guangzhou, China.
J Cereb Blood Flow Metab. 2025 Jan;45(1):32-47. doi: 10.1177/0271678X241295857. Epub 2024 Oct 25.
The increasing prevalence of pathological cerebrovascular conditions, including stroke, hypertensive encephalopathy, and chronic disorders, underscores the importance of anesthetic considerations for affected patients. Preserving cerebral oxygenation and blood flow during anesthesia is paramount to prevent neurological deterioration. Furthermore, protecting vulnerable neurons from damage is crucial for optimal outcomes. Recent research suggests that anesthetic agents may provide a potentially therapeutic approach for managing pathological cerebrovascular conditions. Anesthetics target neural mechanisms underlying cerebrovascular dysfunction, thereby modulating neuroinflammation, protecting neurons against ischemic injury, and improving cerebral hemodynamics. However, optimal strategies regarding mechanisms, dosage, and indications remain uncertain. This review aims to clarify the physiological effects, mechanisms of action, and reported neuroprotective benefits of anesthetics in patients with various pathological cerebrovascular conditions. Investigating anesthetic effects in cerebrovascular disease holds promise for developing novel therapeutic strategies.
包括中风、高血压脑病和慢性疾病在内的病理性脑血管疾病的患病率不断上升,凸显了对受影响患者进行麻醉考量的重要性。麻醉期间维持脑氧合和血流对于预防神经功能恶化至关重要。此外,保护脆弱的神经元免受损伤对于实现最佳预后至关重要。最近的研究表明,麻醉药物可能为治疗病理性脑血管疾病提供一种潜在的治疗方法。麻醉药物针对脑血管功能障碍背后的神经机制,从而调节神经炎症,保护神经元免受缺血性损伤,并改善脑血流动力学。然而,关于作用机制、剂量和适应症的最佳策略仍不确定。本综述旨在阐明麻醉药物在各种病理性脑血管疾病患者中的生理效应、作用机制和已报道的神经保护益处。研究麻醉药物在脑血管疾病中的作用有望开发新的治疗策略。