Is etomidate neuroprotective?

Is etomidate neuroprotective?

Etomidate, a carboxylated imidazole derivative, is a nonbarbiturate anesthetic that is used clinically both as an anesthetic and as a neuroprotective agent.

Is propofol neuroprotective?

Propofol is a short-acting intravenous anaesthetic agent and widely used not only in operating rooms but also in the intensive care unit (ICU). Apart from its multiple anaesthetic advantages, the neuroprotective effect of propofol has been demonstrated in diverse models of neuronal injury.

How does propofol cause cerebral vasoconstriction?

Propofol produces cerebral vasoconstriction indirectly by reducing cerebral metabolism. 17In dogs, propofol has been shown to decrease EEG activity and cerebral metabolism associated with a decrease in CBF.

How does propofol affect cerebral blood flow?

In young healthy adults, propofol anaesthesia, with limited reduction in blood pressure, decreases cerebral blood flow by approximately 50% by a decrease in neuronal activity.

Is propofol a barbiturate?

Propofol is a non-barbiturate sedative, used in hospital settings by trained anesthetists for the induction, maintenance of general anesthesia, and sedation of ventilated adults receiving intensive care, for a period of up to 72 hours.

Does etomidate decrease cerebral blood flow?

Unlike propofol and sodium thiopental, which decrease cerebral blood flow by decreasing cerebral metabolism, etomidate has a direct effect as a cerebral vasoconstrictor.

How does propofol decrease ICP?

Abstract. Barbiturates, etomidate and propofol decrease cerebral blood flow (CBF), mediated by a decrease in cerebral metabolism, thus decreasing intracranial pressure (ICP).

Does propofol cause cerebral vasodilation?

The authors conclude that propofol has a direct vasodilatory effect on the cerebral vessels. This interpretation is based on the fact that after establishing steady state with the propofol infusion, the cerebral blood flow was increased relative to cerebral oxygen demand.

How does lidocaine lower ICP?

The decrease in ICP is most probably related to its sympatholytic activity. Lidocaine also decreases cerebral metabolism and stabilizes cell membranes by blocking membrane sodium channels. Prophylactic lidocaine also obtunds the rise in intraorbital pressure that accompanies tracheal manipulation.

When Should etomidate be avoided?

Etomidate is contraindicated in any patient with a known hypersensitivity reaction. Etomidate is a commonly used sedative during rapid sequence intubation (RSI). Septic patients have an increased risk of developing adrenal suppression, which has been associated with increased mortality in some studies.

Does etomidate cause adrenal suppression?

A well-documented side effect of etomidate is suppression of the adrenal synthesis of cortisol. In a dosedependent fashion, it inhibits adrenal mitochondrial 11-β hydroxylase, the enzyme responsible for the final conversion of 11-deoxycortisol to cortisol (Figure 1).

What drug reverses propofol?

Physostigmine reverses propofol-induced unconsciousness and attenuation of the auditory steady state response and bispectral index in human volunteers. Anesthesiology.

Does etomidate increased ICP?

Conclusions: In pediatric patients with severe traumatic brain injury, single-dose etomidate administration resulted in statistically significant reductions in ICP and improvement in cerebral perfusion pressure without significantly altering MAP.

What characteristic of propofol makes it well suited for intracranial pressure control?

Propofol has no active metabolites and does not produce significant drug interactions. It reduces ICP, CMRO2, CBF and cerebral electrical activity. CO2 vascular reactivity and cerebral autoregulation are also preserved. On the other hand, it has no analgesic effect, and it raises tolerance and tachyphylaxis.

What is CPP nursing?

Cerebral perfusion pressure (CPP) is the amount of pressure needed to maintain blood flow to the brain. CPP is regulated by two balanced opposing forces: Mean arterial pressure (MAP) is the driving force that pushes blood into the brain. Intracranial pressure (ICP) is the force that keeps blood out.

How does succinylcholine increase ICP?

Subsequent to our finding in cats, Lanier et al. found convincing evidence that succinylcholine induces sufficient muscle afferent activity to generate immediate electroencephalographic arousal accompanied by rapidly elevated cerebral blood flow and increased ICP in dogs.