[Sevoflurane and the nervous system].

During sevoflurane anaesthesia cerebral blood flow is preserved or slightly decreased. Cerebral oxygen consumption is reduced to 50% under 1 MAC sevoflurane. Autoregulation of cerebral blood flow and responsiveness of cerebral blood flow to changes in Pa CO2 are widely preserved. Sevoflurane produces a dose dependent increase in intracranial pressure and a decrease in cerebrovascular resistance that can not be observed under hypocapnic conditions. Central stimulus processing, the electroencephalogram and sensory evoked potentials are suppressed under sevoflurane in a dose dependent fashion. The electrophysiological data indicate that intraoperative awareness phenomena should be suppressed with sevoflurane 1.5-2.0 vol.%. Recovery of cognitive and psychomotor functions seems to be faster and more complete after sevoflurane than after isoflurane anaesthesia. In inducing seizure like EEG or muscle activity, sevoflurane seems to be comparable with isoflurane. There is no limitation of sevoflurane use in patients with concomitant psychiatric or neurological diseases, and sevoflurane may be valuable addition in neurosurgery or carotid surgery.