Cerebral autoregulation and anesthesia.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Dagal
Armagan
A
Harborview Medical Center, University Washington, Seattle, WA 98104-2499, USA.
Lam
Arthur M
AM
D000758:Anesthesia; D018681:Anesthetics, General / Q000494:pharmacology*; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply / Q000187:drug effects / Q000502:physiology*; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D006706:Homeostasis / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods; D010313:Partial Pressure; D017585:Ultrasonography, Doppler, Transcranial
D018681:Anesthetics, General; D002245:Carbon Dioxide