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Review

Role of Anesthetics and Their Adjuvants in Neurovascular Protection in Secondary Brain Injury after Aneurysmal Subarachnoid Hemorrhage

1
Department of Anesthesiology, Washington University, St. Louis, MO 63110, USA
2
Department of Neurological Surgery, Washington University, St. Louis, MO 63110, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Hidenori Koyama
Int. J. Mol. Sci. 2021, 22(12), 6550; https://doi.org/10.3390/ijms22126550
Received: 5 May 2021 / Revised: 3 June 2021 / Accepted: 15 June 2021 / Published: 18 June 2021
Aneurysmal rupture accounts for the majority of subarachnoid hemorrhage and is responsible for most cerebrovascular deaths with high mortality and morbidity. Initial hemorrhage severity and secondary brain injury due to early brain injury and delayed cerebral ischemia are the major determinants of outcomes after aneurysmal subarachnoid hemorrhage. Several therapies have been explored to prevent these secondary brain injury processes after aneurysmal subarachnoid hemorrhage with limited clinical success. Experimental and clinical studies have shown a neuroprotective role of certain anesthetics in cerebrovascular disorders including aneurysmal subarachnoid hemorrhage. The vast majority of aneurysmal subarachnoid hemorrhage patients require general anesthesia for surgical or endovascular repair of their aneurysm. Given the potential impact certain anesthetics have on secondary brain injury after SAH, appropriate selection of anesthetics may prove impactful on overall outcome of these patients. This narrative review focuses on the available evidence of anesthetics and their adjuvants in neurovascular protection in aneurysmal subarachnoid hemorrhage and discusses current impact on clinical care and future investigative directions. View Full-Text
Keywords: anesthetics; anesthetic adjuvants; neurovascular protection; aneurysmal subarachnoid hemorrhage; early brain injury; delayed cerebral ischemia; neurological outcomes anesthetics; anesthetic adjuvants; neurovascular protection; aneurysmal subarachnoid hemorrhage; early brain injury; delayed cerebral ischemia; neurological outcomes
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MDPI and ACS Style

Athiraman, U.; Zipfel, G.J. Role of Anesthetics and Their Adjuvants in Neurovascular Protection in Secondary Brain Injury after Aneurysmal Subarachnoid Hemorrhage. Int. J. Mol. Sci. 2021, 22, 6550. https://doi.org/10.3390/ijms22126550

AMA Style

Athiraman U, Zipfel GJ. Role of Anesthetics and Their Adjuvants in Neurovascular Protection in Secondary Brain Injury after Aneurysmal Subarachnoid Hemorrhage. International Journal of Molecular Sciences. 2021; 22(12):6550. https://doi.org/10.3390/ijms22126550

Chicago/Turabian Style

Athiraman, Umeshkumar, and Gregory J. Zipfel 2021. "Role of Anesthetics and Their Adjuvants in Neurovascular Protection in Secondary Brain Injury after Aneurysmal Subarachnoid Hemorrhage" International Journal of Molecular Sciences 22, no. 12: 6550. https://doi.org/10.3390/ijms22126550

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