Key Points

• The complex interplay between the effects of drugs and physiological variables during clinical neuroanesthesia makes the interpretation of experimental data from the use of particular anesthetic drugs in isolation difficult.

• Moderate hyperventilation reduces CBF and brain volume. Extreme hyperventilation may be associated with critical reduction in flow to compromised areas and focal ischemia. Intravenous anesthetics generally decrease cerebral metabolism, CBF and ICP. Inhala-tional agents are all cerebral vasodilators. The overall effect on CBF depends on a balance between the concentration of the inhalational agent and the degree of hyperventilation.

• Pharmacological brain protection has been, so far, disappointing.

• Adequate monitoring must be used when patients are sedated. Supplemental oxygen, equipment and drugs to support the airway, breathing and cardiovascular system must be readily available.

• Close cooperation between the surgeon and the anesthesiologist is absolutely essential.

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Cure Your Yeast Infection For Good

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