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Update on inhalational anaesthetics

De Hert, Stefan G; Preckel, Benedikt; Schlack, Wolfgang S

Current Opinion in Anesthesiology: August 2009 - Volume 22 - Issue 4 - p 491–495
doi: 10.1097/ACO.0b013e32832bca38
Drugs in anesthesia: Edited by Klaus T. Olkkola

Purpose of review Inhalational anaesthetic agents are a cornerstone in modern anaesthetic practice. The currently used compounds are very effective and have a good safety profile. In addition, it has been demonstrated that they possess organ-protective properties that might provide an additional tool in the treatment or prevention of the consequences of organ ischaemia–reperfusion injury or both. The present review summarizes some of the most recent findings on this subject.

Recent findings The mechanisms underlying the organ-protective effects of inhalational anaesthetics continue to be further unravelled. The main challenge, however, is to determine the clinical importance of these protective effects and their potential benefits for patients. Initial observations in cardiac surgery are encouraging, and the first clinical studies on other organ systems are being published. Noble gases share these organ-protective properties and may provide an additional tool for this purpose both in situations in which anaesthesia is needed (xenon) or in cases in which anaesthesia is not necessary (helium).

Summary In the experimental setting, inhalational anaesthetics have protective effects against ischaemia–reperfusion injury. Initial perioperative data suggest that these effects may also result into clinically relevant improved organ function. However, further research will be needed to reveal whether these organ-protective properties will ultimately translate into an improved short-term and long-term postoperative outcome.

Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands

Correspondence to Stefan G. De Hert, MD, PhD, Professor of Anaesthesiology and Chair, Division of Cardiothoracic and Vascular Anaesthesiology, Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100DD Amsterdam, The Netherlands Tel: +31 20 5662533; fax: +31 20 6979441; e-mail: s.g.dehert@amc.uva.nl

© 2009 Lippincott Williams & Wilkins, Inc.