Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Dec;38(12):2192-2208.
doi: 10.1177/0271678X18789273. Epub 2018 Jul 16.

Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection

Andrew M Slupe  1 , Jeffrey R Kirsch  1
Affiliations
Review

Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection

Andrew M Slupe et al. J Cereb Blood Flow Metab. 2018 Dec.

Abstract

Administration of anesthetic agents fundamentally shifts the responsibility for maintenance of homeostasis from the patient and their intrinsic physiological regulatory mechanisms to the anesthesiologist. Continuous delivery of oxygen and nutrients to the brain is necessary to prevent irreversible injury and arises from a complex series of regulatory mechanisms that ensure uninterrupted cerebral blood flow. Our understanding of these regulatory mechanisms and the effects of anesthetics on them has been driven by the tireless work of pioneers in the field. It is of paramount importance that the anesthesiologist shares this understanding. Herein, we will review the physiological determinants of cerebral blood flow and how delivery of anesthesia impacts these processes.

Keywords: Cerebral blood flow; anesthetics; autoregulation; cerebral metabolism; neuroprotection.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Summary of the effects of anesthetic agents on global oxidative-metabolism (GOM) and cerebral blood flow (CBF) as well as the endogenous regulatory mechanisms such as cerebral autoregulation (CA), vasomotor reactivity (VMR) and neurovascular coupling (NVC). See text for additional details.
Figure 2.
Figure 2.
Evolving understanding of the relationship between MAP and CBF. (a) Inter-individual static cerebral autoregulatory curve (adapted from Lassen). (b) Intra-individual static cerebral autoregulatory curve (adapted from Numan et al.). (c) Dynamic cerebral autoregulatory curve (adapted from Tan). MAP: mean arterial pressure; CBF: cerebral blood flow.
See this image and copyright information in PMC

References

    1. Quastel JH, Wheatley AH. Oxidations by the brain. Biochem J 1932; 26: 725–744. - PMC - PubMed
    1. Schoenemann PT. Evolution of the size and functional areas of the human brain. Annu Rev Anthropol 2006; 35: 379–406.
    1. Seymour RS, Bosiocic V, Snelling EP. Fossil skulls reveal that blood flow rate to the brain increased faster than brain volume during human evolution. Royal Soc Open Sci 2016; 3: 160305. - PMC - PubMed
    1. Bélanger M, Allaman I, Magistretti PJ. Brain energy metabolism: focus on astrocyte-neuron metabolic cooperation. Cell Metab 2011; 14: 724–738. - PubMed
    1. Rostrup E, Knudsen GM, Law I, et al. The relationship between cerebral blood flow and volume in humans. Neuroimage 2005; 24: 1–11. - PubMed