Gyulai Ferenc E
Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15237, USA.
Curr Opin Anaesthesiol. 2004 Oct;17(5):397-402. doi: 10.1097/00001503-200410000-00008.
This review focuses on the utilization of the effects of general anesthetics on cerebral metabolism as revealed by imaging for therapeutic and preventive purposes, for understanding mechanisms of anesthetic action, and for elucidating mechanisms of cerebral processing in humans.
General anesthetics suppress cerebral metabolism significantly. This effect has been used for neuroprotection during inadequate cerebral blood flow. With the advent of noninvasive imaging techniques, this suppression has also been used to image and map the sites of anesthetic action in the living human brain. Volatile agents, intravenous anesthetics, and analgesics have all begun to be explored using mostly positron emission tomography. The ability of anesthetics to change global baseline brain metabolism has created the opportunity to examine the relevance of global baseline (resting) brain activity in terms of region-specific cerebral processing.
Anesthetics experimentally appear to be useful for neuroprotection, at least during the early post-ischemic period. Identification of the cerebral sites of anesthetic action by in vivo human brain imaging provides new insights into the mechanism of action of these agents. Anesthetic-related manipulation of baseline brain metabolism demonstrates the significant contribution of this global activity to regional cerebral processing.
本综述聚焦于通过成像揭示全身麻醉药对脑代谢的影响，以用于治疗和预防目的，理解麻醉作用机制，以及阐明人类脑加工机制。
全身麻醉药显著抑制脑代谢。这种作用已被用于在脑血流量不足时进行神经保护。随着非侵入性成像技术的出现，这种抑制作用也被用于对活体人类大脑中麻醉作用位点进行成像和定位。挥发性麻醉药、静脉麻醉药和镇痛药大多已开始使用正电子发射断层扫描进行研究。麻醉药改变全脑基线代谢的能力为从区域特异性脑加工角度研究全脑基线（静息）脑活动的相关性创造了机会。
实验表明，麻醉药至少在缺血后早期似乎对神经保护有用。通过活体人类脑成像确定麻醉作用的脑位点为这些药物的作用机制提供了新见解。与麻醉相关的对基线脑代谢的调控表明这种全局活动对区域脑加工有重要贡献。
