Central Nervous System Anesthesia: Asleep Approach

Abstract

The knowledge of the mechanisms at play on the physiology of the central nervous system (CNS) is crucial for the anesthesia during surgical procedures in the encephalus and the medulla. Anesthesia may modify the CNS by acting on: a) extrinsic conditions such as changes in CO2 partial pressure, O2 partial pressure, systemic arterial pressure, body temperature, and intravascular blood volume replacement; and b) intrinsic conditions such as increased or decreased cerebral metabolic rates (CMRO2). These changes can increase or decrease cerebral blood flow (CBF), cerebral blood volume (CBV), and intracranial pressure (ICP), modifying cerebral perfusion pressure (CPP). During the surgical procedure, when the CNS is monitored to reduce aggression, it is essential to consider the effects of anesthesia since physiological changes and the effects of anesthetics can interfere with this monitoring, making it difficult to detect signs of possible mechanical aggressions due to the surgical procedure on the CNS. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.