Lomivorotov Vladimir V, Moroz Gleb, Abubakirov Marat, Osinsky Roman, Landoni Giovanni
Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk, Russia; Department of Anesthesiology and Intensive Care, Novosibirsk State University, Novosibirsk, Russia.
Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk, Russia.
J Cardiothorac Vasc Anesth. 2022 Feb;36(2):567-576. doi: 10.1053/j.jvca.2021.02.048. Epub 2021 Feb 22.
Postoperative neurologic complications have a significant effect on morbidity, mortality, and long-term disability in patients undergoing cardiac surgery. The etiology of brain injury in patients undergoing cardiac surgery is multifactorial and remains unclear. There are several perioperative causative factors for neurologic complications, including microembolization, hypoperfusion, and systemic inflammatory response syndrome. Despite technologic advances and the development of new anesthetic drugs, there remains a high rate of postoperative neurologic complications. Moreover, despite the strong evidence that volatile anesthesia exerts cardioprotective effects in patients undergoing cardiac surgery, the neuroprotective effects of volatile agents remain unclear. Several studies have reported an association of using volatile anesthetics with improvement of biochemical markers of brain injury and postoperative neurocognitive function. However, there is a need for additional studies to define the optimal anesthetic drug for protecting the brain in patients undergoing cardiac surgery.
术后神经并发症对接受心脏手术患者的发病率、死亡率及长期残疾有显著影响。心脏手术患者脑损伤的病因是多因素的，目前仍不清楚。围手术期有多种导致神经并发症的因素，包括微栓塞、灌注不足和全身炎症反应综合征。尽管技术进步且新型麻醉药物不断研发，但术后神经并发症的发生率仍然很高。此外，尽管有强有力的证据表明挥发性麻醉剂对接受心脏手术的患者具有心脏保护作用，但其神经保护作用仍不明确。多项研究报告称，使用挥发性麻醉剂与脑损伤生化标志物改善及术后神经认知功能改善有关。然而，仍需要更多研究来确定保护接受心脏手术患者大脑的最佳麻醉药物。
