Cerebral Protection

Basically I think that barbiturates predominantly act by inverse steal (flow redistribution) and possbily also by inhibition of the effects of excitatory neurotransmitters, rather than by reduction in metabolic rate per se.

I think they have a definite place in situations of regional cerebral hypoperfusion (ie carotid endarterectomy) but little place in global insults (such as profound deliberate hypothermia).

I will expand on this in detail as soon as I can.

If you have a special interest in this area do not hesitate to contact me.