Utjecaj inhalacijskih anestetika na moždani protok krvi

master's thesis

• Title (english): Effect of inhalation anesthetics on cerebral blood flow
• Author: Antonio Marketin
• 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 Anatomy and Clinical Anatomy); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Primarni cilj anestezije je održavanje fiziološke homeostaze. To zahtijeva monitoring i tretman kardiovaskularnih, respiratornih, neuroloških i bubrežnih funkcijskih promjena tokom perioperativnog perioda kako bi se minimizirali neželjeni ishodi. Optimiziranje fiziologije pacijenta u intraoperativnom periodu može ubrzati oporavak i pružiti protekciju organskih sustava. Znanje o utjecaju anestetika na moždani protok krvi i metabolizam je potrebno kako bi se pacijentu osigurala sigurna anestezija. Jaki halogenirani inhalacijski anestetici uzrokuju vazodilataciju moždanog krvožilja ovisno o dozi. Unatoč tome što smanjuju metabolizam mozga, povećavaju moždani protok krvi kroz mozak ovisno o dozi gubitkom sveze protokmetabolizam. Međutim, potpuni gubitak te sveze se ne događa. Moždana autoregulacija se mijenja ovisno o dozi. Smanjenje moždanog metabolizma uzrokuje smanjenje protoka krvi, no tome se suprotstavlja direktni vazodilatacijski učinak inhalacijskih anestetika. Održavanje odgovarajuće razine intrakranijalnog tlaka je izuzetno bitno za neurokirurške pacijente. Stupanj do kojeg jaki halogenirani inhalacijski agensi povećavaju moždani protok krvi, te tako i intrakranijalni tlak ovisi o zbroju posrednog vazokonstrikcijskog i izravnog vazodilatacijskog učinka. Dušični oksidul povećava moždani protok krvi, kao i moždani metabolizam. Ksenon povećava moždani protok krvi.

Abstract (english)

The primary goal of anesthesia is the maintenance of physiologic homeostasis. This includes monitoring and treatment of cardiovascular, pulmonary, neurologic and kidney functions changes during the perioperative period to minimize adverse outcomes. Optimizing intraoperative physiology may help speed recovery and provide for perioperative organ system protection. Knowledge of the influence of anesthetics on cerebral blood flow and metabolism is important for safe anesthesia practice.The potent halogenated inhalation anesthetics are all dosedependent cerebral vasodilators. While they reduce cerebral metabolic rate (CMR), they can blunt cerebral autoregulation by uncoupling cerebral blood flow (CBF) and metabolism and subsequently increase CBF. However, total uncoupling of the CBF and metabolism does not happen. Cerebral autoregulation is dose-dependently altered. Brain metabolism decreases which causes a decrease in CBF. That is counteracted by the direct vasodilatation of brain blood vessels by volatile anesthetics. Maintaining adequate ICP levels is crucial for neurosurgical patients. The degree to which the potent halogenated inhalation agents increase CBF and therefore intracranial pressure (ICP) depends on sum of the mediated vasoconstriction and the direct vasodilatation . Nitrous oxide gas increases cerebral metabolism and cerebral blood flow. Xenon increases cerebral blood flow as well.

• Keywords: inhalacijski anestetik; moždani protok krvi; CNS
• Keywords (english): inhalation anesthetic; cerebral blood flow; CNS
• Language: croatian
• URN:NBN: urn:nbn:hr:105:489609
• 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: 2018-01-11 13:57:40