It occurred to me today that anesthesia gases (isoflurane, desflurane, sevoflurane) are cerebral vasodilators that are usually used for endovascular and open cerebral procedures. Why not use them to treat vasospasm in high risk intubated patients? They would offer a constant level of the drug (rather than the peaks and troughs of calcium channel blockers) for however long it was needed. ICUs are already using them for status asthmaticus and ventilators with the vaporizers can be obtained from anesthesia departments. They would probably need to be run with a background phenylephrine drip since they also cause peripheral vasodilation.
Looking at the literature, I only found papers stating the fluranes can be used for cerebral protection, a paper on isoflurane not causing vasospasm, and papers on it causing cerebral vasodilation. Anyone else ever read something on this topic?
06-14-2012, 09:26 AM
anesthesia gases for the treatment of vasospasm
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