Key result
Despite advances in laboratory research, there is currently no clinically available pharmacological neuroprotective drug, requiring reliance on non-pharmacological modalities to prevent brain injury.
In the absence of clinically available pharmacological neuroprotectants, anaesthesiologists must rely on non-pharmacological strategies and neuromonitoring to prevent perioperative brain injury.
Absence of pharmacological neuroprotectants necessitates non-pharmacological strategies; leaves open targeted drug development for perioperative brain injury.
The anaesthetized brain is vulnerable to ischaemic insults, which could result in neurological deficits ranging from neuropsychological disturbances to stroke and even death. The risk of perioperative brain injury is relatively high in cardiac, neurosurgical and major vascular surgery, although it has also rarely been reported in noncardiac nonneurosurgical operations. Besides underlying risk factors such as cerebrovascular disease, advanced age, and cardiovascular disease, anaesthesia and surgery per se could also be a contributory factor. The anaesthesiologist plays a pivotal role in protecting the anaesthetized brain, both by taking preventive measures and instituting brain protection strategies. Despite advances and breakthroughs in pharmacological neuroprotection in the laboratory, currently there is no drug, anaesthetic or non-anaesthetic, which is available for clinical use. The anaesthesiologist has to rely on non-pharmacological modalities and neuromonitoring to prevent intraoperative brain injury
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Mary Abraham (2014) conducted a review in Perioperative cerebral ischaemia. Perioperative neuroprotection strategies was evaluated. Despite advances in laboratory research, there is currently no clinically available pharmacological neuroprotective drug, requiring reliance on non-pharmacological modalities to prevent brain injury.
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