Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances

Fospropofol is a water-soluble prodrug of propofol that has gained increasing attention in the field of anesthesia due to its gentle modulation of cerebral blood flow and metabolism. This review summarizes the pharmacological mechanisms by which fospropofol regulates cerebral hemodynamics, including...

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Main Authors: Luying Huang, Hui Yang
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:https://journals.lww.com/10.4103/sja.sja_230_25
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author Luying Huang
Hui Yang
author_facet Luying Huang
Hui Yang
author_sort Luying Huang
collection DOAJ
description Fospropofol is a water-soluble prodrug of propofol that has gained increasing attention in the field of anesthesia due to its gentle modulation of cerebral blood flow and metabolism. This review summarizes the pharmacological mechanisms by which fospropofol regulates cerebral hemodynamics, including direct effects on vascular smooth muscle and indirect modulation via suppression of neural metabolic activity. The article also discusses its ability to reduce cerebral metabolic rate, inhibit neuronal excitability, and modulate energy balance, all of which contribute to its potential neuroprotective properties, particularly in ischemia-reperfusion injury. Preclinical and clinical studies suggest that fospropofol exerts antioxidant and anti-inflammatory effects that may further support neural preservation. Clinically, fospropofol has shown value in various scenarios requiring precise neuromanagement, including neurosurgery, anesthesia in elderly patients, intensive care sedation, and perioperative neuroprotection. Despite promising results, further high-quality, large-scale studies are needed to clarify its neuroprotective efficacy across diverse patient populations and surgical contexts. With its favorable pharmacokinetics, controllable depth of sedation, and multitargeted neural effects, fospropofol is poised to become an important tool in individualized neuroanesthesia and brain-protective strategies.
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spelling doaj-art-0e2f7ff8bf944461b7697d44f63d2ed02025-08-20T03:29:40ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-07-0119338739410.4103/sja.sja_230_25Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advancesLuying HuangHui YangFospropofol is a water-soluble prodrug of propofol that has gained increasing attention in the field of anesthesia due to its gentle modulation of cerebral blood flow and metabolism. This review summarizes the pharmacological mechanisms by which fospropofol regulates cerebral hemodynamics, including direct effects on vascular smooth muscle and indirect modulation via suppression of neural metabolic activity. The article also discusses its ability to reduce cerebral metabolic rate, inhibit neuronal excitability, and modulate energy balance, all of which contribute to its potential neuroprotective properties, particularly in ischemia-reperfusion injury. Preclinical and clinical studies suggest that fospropofol exerts antioxidant and anti-inflammatory effects that may further support neural preservation. Clinically, fospropofol has shown value in various scenarios requiring precise neuromanagement, including neurosurgery, anesthesia in elderly patients, intensive care sedation, and perioperative neuroprotection. Despite promising results, further high-quality, large-scale studies are needed to clarify its neuroprotective efficacy across diverse patient populations and surgical contexts. With its favorable pharmacokinetics, controllable depth of sedation, and multitargeted neural effects, fospropofol is poised to become an important tool in individualized neuroanesthesia and brain-protective strategies.https://journals.lww.com/10.4103/sja.sja_230_25anesthesiacerebral blood flowcerebral metabolismfospropofolneuroprotectionindividualized anesthesiaintravenous sedationneurosurgery
spellingShingle Luying Huang
Hui Yang
Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
Saudi Journal of Anaesthesia
anesthesia
cerebral blood flow
cerebral metabolism
fospropofol
neuroprotection
individualized anesthesia
intravenous sedation
neurosurgery
title Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
title_full Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
title_fullStr Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
title_full_unstemmed Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
title_short Regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications: Recent advances
title_sort regulatory mechanisms of fospropofol on cerebral blood flow and metabolism and its clinical applications recent advances
topic anesthesia
cerebral blood flow
cerebral metabolism
fospropofol
neuroprotection
individualized anesthesia
intravenous sedation
neurosurgery
url https://journals.lww.com/10.4103/sja.sja_230_25
work_keys_str_mv AT luyinghuang regulatorymechanismsoffospropofoloncerebralbloodflowandmetabolismanditsclinicalapplicationsrecentadvances
AT huiyang regulatorymechanismsoffospropofoloncerebralbloodflowandmetabolismanditsclinicalapplicationsrecentadvances