Many surgeries present ischemic risk to the brain. For example, the rate of brain
ischemia after major cardiac surgery ranges between 3%–6% and the occurrence of brain
ischemia greatly increases the length of hospital stay, the cost of care, and overall
mortality [
[1]
]. Therefore, there is great interest in the potential use of pharmacologic and nonpharmacologic
measures to reduce neurologic sequelae in the growing patient population at risk for
ischemic brain injury secondary to either cardiovascular comorbidities, such as atrial
fibrillation, or high-risk procedures including cardiac surgery and intracranial aneurysm
clipping. It is scientifically and practically important to determine whether anesthetics
are neuroprotective. Unfortunately, controversies exist in the efficacy of anesthetics
to induce neuroprotection in animal studies. This issue, combined with the lack of
controlled human studies, contributes to the difficulty of incorporating laboratory
evidence of neuroprotective qualities of anesthetic agents into clinical practice.
This article describes current knowledge of the mechanism for ischemic neuronal injury
and outlines the potential of anesthetic agents to protect the central nervous system
during ischemia.To read this article in full you will need to make a payment
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