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Volatile Anesthetics
The pattern of volatile anesthetic effects on cerebral physi- ology is quite different than that of intravenous anesthetics, which generally cause parallel reductions in CMR and CBF.
All volatile anesthetics, in a manner similar to intravenous sedative-hypnotic drugs, suppress cerebral metabolism in a dose-related fashion.129-132 Volatile anesthetics also possess intrinsic cerebral vasodilatory activity as a result of direct effects on vascular smooth muscle.
The net effect of volatile anesthetics on CBF is therefore a balance between a reduc- tion in CBF caused by CMR suppression and an augmen- tation of CBF caused by the direct cerebral vasodilation.
The increase in CBF produced by volatile anesthetics at doses larger than 1 MAC has been referred to as reflecting a loss of neurovascular coupling.
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