Vascular Integrity: Relevance in Anesthesia Implementation

Authors

  • Anongnat Wuttiprom Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Wilaiporn Supan Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Sirijunya Junyatham Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Phongthara Vichitvejpaisal Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Keywords:

anesthesia implication, biomarkers, blood vessel function, vascular integrity

Abstract

This comprehensive review delves into the intricate relationship between vascular integrity and anesthesia implementation. Anesthetic agents can influence blood vessel function, leading to vasodilation or vasoconstriction, which in turn affect blood pressure, oxygen delivery, and tissue healing. Compromised vascular integrity poses risks for perioperative complications, delayed wound healing, and thrombosis. Robust monitoring techniques, non-invasive tools like ultrasound and doppler, and biomarkers enable real-time assessment and optimization of vascular function intra-operatively. Strategies for preserving vascular integrity span preoperative optimization, fluid management, and tailored pharmacological interventions. Emerging technologies, potential research areas, and personalized medicine approaches in anesthesia practice offer exciting prospects for the future.

References

Daneman R, Prat A. The blood–brain barrier. Cold Spring Harb Perspect Biol. 2015;7:a020412.

Okonkwo UA, Chen L, Ma D, et al. Compromised angiogenesis and vascular integrity in impaired diabetic wound healing. PLoS One. 2020;15:e0231962.

Slupe AM, Kirsch JR. Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection. J Cereb Blood Flow Metab. 2018;38:2192-208.

Riedel B, Rafat N, Browne K, Burbury K, Schier R. Perioperative implications of vascular endothelial dysfunction: current understanding of this critical sensor-effector organ. Curr Anesthesiol Rep. 2013;3:151-61.

Taylor AM, Bordoni B. Histology, blood vascular system. StatPearls 2023 [cited 2023 Dec 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553217/

Krüger-Genge A, Blocki A, Franke RP, Jung F. Vascular endothelial cell biology: an update. Int J Mol Sci. 2019;20:4411.

Li WW, Carter MJ, Mashiach E, Guthrie SD. Vascular assessment of wound healing: a clinical review. Int Wound J. 2017;14:460-9.

Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing: a cellular perspective. Physiol Rev. 2019;99:665-706.

Zanoli L, Briet M, Empana JP, et al. Vascular consequences of inflammation: a position statement from the ESH working group on vascular structure and function and the artery society. J Hypertens. 2020;38:1682-98.

Aguirre JA, Lucchinetti E, Clanachan AS, Plane F, Zaugg M. Unraveling interactions between anesthetics and the endothelium, update and novel insights. Anesth Analg. 2016;122:330-48.

Tamunobelema DMS, Uruaka CI. General anaesthetic agents and their implication on the cardiovascular system: a systematic review. Saudi J Med Pharm Sci. 2023;9:171-84.

Xu J, Xu W, Zhu J. Propofol suppresses proliferation and invasion of glioma cells by upregulating microRNA-218 expression. Mol Med Rep. 2015;12:4815-20.

Eis S, Kramer J. Anesthesia inhalation agents and their cardiovascular effects. StatPearls 2023 [cited 2023 June 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541090/

Mokhtar SS, Rasool AHG. Role of endothelium-dependent hyperpolarisation and prostacyclin in diabetes. Malays J Med Sci. 2015;22:8-17.

Tait A, Howell SJ. Preoperative hypertension: perioperative implications and management. BJA Educ. 2021;21:426-32.

Colson P, Gaudard P. Hypertension and anesthesia: what’s new? J Hypertens Manag. 2016;2:013.

Liou TC, Lin SC, Wang HY, Chang WH. Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleeding. World J Gastroenterol. 2006;12:3108-13.

Papworth D. Intraoperative monitoring during vascular surgery. Anesthesiol Clin North Am. 2004;22:223-50.

Yancey R. Anesthetic management of the hypertensive patient: part II. Anesth Prog. 2018;65:206-13.

McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practice. J Wound Ostomy Continence Nurs. 2014;41:415-23.

Kaurl R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovasc Diabetol. 2018;17:121.

Sessler DI, Bloomstone JA, Aronson S, et al. Perioperative quality initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth. 2019;122:563-74.

Meng L, Yu W, Wang T, Zhang L, Heerdt PM, Gelb AW. Blood pressure targets in perioperative care. Hypertension. 2018;72:806-17.

Malbrain MLNG, Langer T, Annane D, et al. Intravenous fluid therapy in the perioperative and critical care setting: executive summary of the International Fluid Academy (IFA). Ann Intensive Care. 2020;10:64.

Flumignan CD, Nakano LC, Baptista-Silva JC, Flumignan RL. Antiplatelet agents for the treatment of deep venous thrombosis. Cochrane Database Syst Rev. 2022;7:CD012369.

Higashi Y. Roles of oxidative stress and inflammation in vascular endothelial dysfunction-related disease. Antioxidants. 2022;11:1958.

Potapov A, Matveev L, Moiseev A, et al. Multimodal OCT control for early histological signs of vulvar lichen sclerosus recurrence after systemic PDT: pilot study. Int J Mol Sci. 2023;24:13967.

Chia PY, Teo A, Yeo TW. Overview of the assessment of endothelial function in humans. Front Med. 2020;7:542567.

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Published

2025-01-07

How to Cite

Wuttiprom, A., Supan, W., Junyatham, S., & Vichitvejpaisal, P. (2025). Vascular Integrity: Relevance in Anesthesia Implementation. Thai Journal of Anesthesiology, 51(1), 47–56. retrieved from https://he02.tci-thaijo.org/index.php/anesthai/article/view/273058

Issue

Vol. 51 No. 1 (2025): January-February

Section

Review articles

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