Djelovanje intravenskih anestetika na moždani protok krvi

master's thesis

• Title (english): The effect of intravenous anesthetics on cerebral blood flow
• Author: Marko Tripković
• Mentor: Ante Sekulić (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Ante Sekulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Intravenski anestetici se danas široko primjenjuju pri anesteziološkim postupcima. Počeli su se primjenjivati sredinom 20. stoljeća, te se od tada intenzivno proučavaju. Najprije su se počeli primjenjivati barbiturati, a kasnije su se u kliničku praksu uveli benzodiazepini, etomidat, ketamin te propofol. Međusobno se razlikuju po farmakokinetici, mehanizmu djelovanja na CNS, djelovanju na druge sustave te nuspojavama. Osobina svih intravenskih anestetika je brzi nastup djelovanja, a zbog osobitosti moždanog protoka i zbog njihovog vezanja na lipide djelovanje na CNS se očituje brzim nastupom sedacije i anestezije.
Djelovanje je, osim midazolama koji je predstavnik benzodiazepina kratkotrajno, jer se brzo izlučuju iz organizma te im brzo pada koncentracija u CNS-u.
U svim studijama o intravenskim anesteticima posebno se istražuje učinak na moždani protok, te moguće protektivno djelovanje na CNS. Svojim učinkom na moždani metabolizam, kao i učinkom na vrijednosti krvnog tlaka smanjuju moždani protok i potrošnju kiskika u CNS-u. Iznimku od ovog učinka predstavlja ketamin, koji povećava moždani protok i vrijednosti intrakranijalnog tlaka što ograničava njegovu upotrebu kod nekih pacijenata.

Abstract (english)

Today intravenous anesthetics are in usage in many of the anesthetics procedures. They have been used since the middle of the 20th century and since then are focus of many studies. First to use were barbiturates, and later benzodiazepines, etomidate, ketamine and propofol. The differences between them are in pharmacokinetics, effects on CNS, and effects on other systems and side effects. Their main feature are rapid action, and due to the characteristics of the cerebral blood flow and their binding to lipids rapid onset of sedation and anesthesia. Their effect is shorterm besides midazolam who is a benzodiazepine, because they are rapidly excreted from the body and their concentration decreases in CNS.
In every intravenous anesthetics study their is a part that deals with their influence on cerebral blood flow, and possibly their protective CNS features. With their effect on cerebral metabolism, as their effect on blood pressure they decrease cerebral blood flow and cerebral oxygen consumption. The exception is ketamine which increases cerebral blood flow and intracranial pressure that limit its usage in some patients.

• Keywords: moždani protok; intravenski anestetik; CNS
• Keywords (english): cerebral blood flow; intravenous anestethic; CNS
• Language: croatian
• URN:NBN: urn:nbn:hr:105:452178
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-10-19 09:20:00