Traumatic brain injury: neuroprotective anaesthetic techniques, an update.
Traumatic brain injuries remain an area of great challenge to both neurosurgeons and neuroanaesthesiologists. The management of these injuries starts at the scene of the accident. However, strategies for preventing secondary brain injury and its sequelae are continuing to evolve. These strategies include the use of pharmacological and nonpharmacological techniques. Preventing hypoxia and the use of hypertonic saline have been shown to have favourable results on the outcome of these injuries. The use of isoflurane has been shown to have a neuronprotective effect. Propofol is thought to be the future drug of choice because of its neuroprotective properties, although these still need to be further proven through research. In this review an understanding of the pathophysiology of traumatic brain injury will be outlined in order to understand the effects of pharmacological and nonpharmacological agents on secondary brain injury.
Tawfeeq
Nasser A
NA
Department of Anaesthesia, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Halawani
Mohammed M
MM
Al-Faridi
Khulood
K
Aal-Shaya
Wa'el A
WA
Taha
Wa'el S
WS
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016923:Cell Death / Q000187:drug effects / Q000502:physiology; D002492:Central Nervous System Depressants / Q000627:therapeutic use; D006259:Craniocerebral Trauma / Q000150:complications* / Q000628:therapy; D016572:Cyclosporine / Q000494:pharmacology; D020927:Dexmedetomidine / Q000494:pharmacology; D004921:Erythropoietin / Q000494:pharmacology; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000628:therapy*; D019585:Intracranial Hypotension / Q000209:etiology / Q000628:therapy; D007530:Isoflurane / Q000494:pharmacology; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D009609:Nitrous Oxide / Q000627:therapeutic use; D019990:Perioperative Care / Q000379:methods*; D015742:Propofol / Q000494:pharmacology; D012151:Resuscitation / Q000379:methods; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D014978:Xenon / Q000494:pharmacology; D055815:Young Adult
D002492:Central Nervous System Depressants; D018696:Neuroprotective Agents; D012462:Saline Solution, Hypertonic; D004921:Erythropoietin; D014978:Xenon; D020927:Dexmedetomidine; D016572:Cyclosporine; D007530:Isoflurane; D009609:Nitrous Oxide; D015742:Propofol