Adembri Chiara, Venturi Luna, Pellegrini-Giampietro Domenico E
Section of Anesthesiology and Intensive Care, Department of Critical Care, University of Florence, Italy.
CNS Drug Rev. 2007 Fall;13(3):333-51. doi: 10.1111/j.1527-3458.2007.00015.x.
Propofol (2,6-diisopropylphenol) is one of the most popular agents used for induction of anesthesia and long-term sedation, owing to its favorable pharmacokinetic profile, which ensures a rapid recovery even after prolonged administration. A neuroprotective effect, beyond that related to the decrease in cerebral metabolic rate for oxygen, has been shown to be present in many in vitro and in vivo established experimental models of mild/moderate acute cerebral ischemia. Experimental studies on traumatic brain injury are limited and less encouraging. Despite the experimental results and the positive effects on cerebral physiology (propofol reduces cerebral blood flow but maintains coupling with cerebral metabolic rate for oxygen and decreases intracranial pressure, allowing optimal intraoperative conditions during neurosurgical operations), no clinical study has yet indicated that propofol may be superior to other anesthetics in improving the neurological outcome following acute cerebral injury. Therefore, propofol cannot be indicated as an established clinical neuroprotectant per se, but it might play an important role in the so-called multimodal neuroprotection, a global strategy for the treatment of acute injury of the brain that includes preservation of cerebral perfusion, temperature control, prevention of infections, and tight glycemic control.
丙泊酚（2,6-二异丙基苯酚）是用于麻醉诱导和长期镇静的最常用药物之一，这归因于其良好的药代动力学特性，即使在长时间给药后也能确保快速恢复。在许多轻度/中度急性脑缺血的体外和体内既定实验模型中，已显示出丙泊酚具有除与脑氧代谢率降低相关之外的神经保护作用。关于创伤性脑损伤的实验研究有限且不太令人鼓舞。尽管有实验结果以及对脑生理的积极影响（丙泊酚可减少脑血流量，但维持与脑氧代谢率的耦合并降低颅内压，从而在神经外科手术期间实现最佳术中条件），但尚无临床研究表明丙泊酚在改善急性脑损伤后的神经功能结局方面优于其他麻醉剂。因此，丙泊酚本身不能被指定为既定的临床神经保护剂，但它可能在所谓的多模式神经保护中发挥重要作用，多模式神经保护是一种治疗急性脑损伤的整体策略，包括维持脑灌注、控制体温、预防感染和严格控制血糖。
