Journal
JOURNAL OF ANESTHESIA
Volume 21, Issue 2, Pages 220-231Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s00540-006-0487-5
Keywords
vascular smooth muscle; vascular endothelium; intracellular Ca2+ concentration; myofilament Ca2+ sensitivity
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General anesthetics cause hemodynamic instability and alter blood flow to various organs. There is mounting evidence that most general anesthetics. at clinical concentrations, influence a wide variety of cellular and molecular mechanisms regulating the contractile state of vascular smooth muscle cells (i.e., vascular tone). In addition, in current anesthetic practice, various types of vasoactive agents are often used to control vascular reactivity and to sustain tissue blood flow in high-risk surgical patients with impaired vital organ function and/or hemodynamic instability. Understanding the physiological mechanisms involved in the regulation of vascular tone thus would be beneficial for anesthesiologists. This review, in two parts, provides an overview of current knowledge about the cellular and molecular mechanisms regulating vascular tone-i.e., targets for general anesthetics. as well as for vasoactive drugs that are used in intraoperative circulatory management. This first part of the two-part review focuses on basic mechanisms regulating cytosolic Call concentration and the Ca2+-dependent regulation of vascular tone.
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