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Anesthesia and the Microcirculation

Publication at First Faculty of Medicine, Faculty of Medicine in Pilsen, Faculty of Medicine in Hradec Králové |
2009

Abstract

There is increasing evidence that the microcirculation and its regulation are severely compromised during many pathological conditions, such as hemorrhage, sepsis, or trauma. The effect of anesthetic agents on macrohemodynamics were investigated intensively in the last several decades.

Research regarding modern anesthetics and anesthesia techniques has increased knowledge regarding the nonanesthetic effects of anesthetic agents, including those on organ perfusion and the microcirculation. Alterations in microvascular reactivity, nitric oxide pathways, and cytokine release are presumably the main mechanisms of anesthetic-induced tissue perfusion changes.

This review summarizes current methods of microcirculatory status assessment and current knowledge regarding the microcirculatory effect of intravenous and potent volatile anesthetics and anesthesia-related techniques under both normal and pathophysiological conditions.