Cerebral autoregulation and anesthesia

This review will examine the recent literature on anesthesia and monitoring techniques in relation to cerebral autoregulation. We will discuss the effect of physiologic and pharmacological factors on cerebral autoregulation alongside its clinical relevance with the help of new evidence. Intravenous anesthesia, such as combination of propofol and remifentanil, provides best preservation of autoregulation. Among inhaled agents sevoflurane appears to preserve autoregulation at all doses, whereas with other agents autoregulation is impaired in a dose-related manner. Intraoperative cerebral autoregulation monitoring is an important consideration for the patients with neurologic disease. Transcranial Doppler based static autoregulation measurements appears to be the most robust bedside method for this purpose.