Influence of general anaesthesia on the brainstem

• Published in: Revista española de anestesiología y reanimación Vol. 64; no. 3; p. 157
• Main Authors: Bosch, L, Fernández-Candil, J, León, A, Gambús, P L
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-03-2017
• Subjects: Adrenergic alpha-2 Receptor Agonists - pharmacology; Analgesics, Opioid - pharmacology; Anesthesia, General; Anesthetics, General - pharmacology; Animals; Brain Stem - drug effects; Brain Stem - physiology; Cerebral Cortex - drug effects; Cerebral Cortex - physiology; Consciousness - drug effects; Consciousness - physiology; Cranial Nerves - drug effects; Cranial Nerves - physiology; Diagnostic Techniques, Neurological; Electroencephalography; Evoked Potentials - drug effects; GABA-A Receptor Agonists - pharmacology; Humans; Hypnotics and Sedatives - pharmacology; Magnetic Resonance Imaging; Mice; Neuroimaging; Reflex - drug effects; Funciones vitales; Reflex; Vital functions; Brainstem; Exploración neurológica; Pares craneales; Anaesthesia; Cranial nerves; Anestesia; Neurological examination; Reflejo; Propofol; Tronco encefálico
• ISSN: 2340-3284
• DOI: 10.1016/j.redar.2016.09.005

The exact role of the brainstem in the control of body functions is not yet well known and the same applies to the influence of general anaesthesia on brainstem functions. Nevertheless in all general anaesthesia the anaesthesiologist should be aware of the interaction of anaesthetic drugs and brainstem function in relation to whole body homeostasis. As a result of this interaction there will be changes in consciousness, protective reflexes, breathing pattern, heart rate, temperature or arterial blood pressure to name a few. Brainstem function can be explored using three different approaches: clinically, analyzing changes in brain electric activity or using neuroimaging techniques. With the aim of providing the clinician anaesthesiologist with a global view of the interaction between the anaesthetic state and homeostatic changes related to brainstem function, the present review article addresses the influence of anaesthetic drug effects on brainstem function through clinical exploration of cranial nerves and reflexes, analysis of electric signals such as electroencephalographic changes and what it is known about brainstem through the use of imaging techniques, more specifically functional magnetic resonance imaging.