Table 4.

Anesthetics and adjuvants in delayed cerebral ischemia (DCI) after SAH in patients.

References	Anesthetic Agent/Adjuvants	Sample Size	Effects
[34]	Desflurane	45	ET-1 ↓. May reduce the risk of acute cerebral vasospasm.
[35]	Desflurane/Propofol	102	Less incidence of TCD-evident vasospasm with desflurane.
[36]	Desflurane	157	Lower incidence of DCI.
[37]	Sevoflurane/Desflurane	390	Lower incidence of angiographic vasospasm and DCI.
[38]	Desflurane/Propofol	70	No effects on POCD at the time of discharge.
[39]	Propofol	45	CGRP↓. May potentiate the risk of acute cerebral vasospasm.
[41]	Propofol	66	No effect on cognition at time of hospital discharge.
[40]	Ketamine, midazolam, propofol	31	Ketamine ↓ the occurrence of spreading depolarization’s, clusters of spreading depolarization’s and isoelectric spreading depolarizations. (NMDA ↓) Midazolam ↑ spreading depolarization clusters. (GABA ↓). Propofol ↓ clusters of spreading depolarizations.
[42]	Ketamine	65	Lower incidence of non-procedural related infarctions probably through NMDA ↓, ↓ cortical spreading depolarization and vasodilation.
[43]	Ketamine	1	NMDA ↓. Cortical spreading depolarization ↓.
[44]	Ketamine	8	↓ spreading depolarizations.
[45]	Ketamine	66	↓ spreading depolarizations.
[50]	Dexmedetomidine	161	Favorable neurologic outcome at discharge as measured by mRS.
[49]	Dexmedetomidine	127	No impact on vasospasm or clinical outcome at discharge as measured by mRS and GOS.
[51]	flunitrazepam, midazolam, propofol	29	Associated with poor outcomes at 6 months after discharge as measured by GOS.

↑ = Activation/Increase/elevation, ↓ = Inhibition/blockade/decrease, ET-1 = endothelin, TCD = transcranial Doppler, CGRP = calcitonin gene- related peptide, GABA = Gamma- aminobutyric acid, NMDA = N-methyl- D- Aspartate, POCD = post-operative cognitive dysfunction, mRS = modified Rankin scale, GOS = Glasgow outcome scale.