周術期の血管機能保護戦略

Potassium channels play an essential role in the membrane potential of arterial smooth muscle, and also in regulating contractile tone. Especially, in vascular smooth muscle, the opening of adenosine triphosphate（ATP）-sensitive potassium（KATP）channels leads to membrane hyperpolarization, resulting in muscle relaxation and vasodilation. This activation also plays a role in tissues during pathophysiologic events such as ischemia, hypoxia, and vasodilatory shock. In this review, we will describe the physiological and pathophysiological roles of vascular smooth muscle KATP channels in relation to the effects of anesthetics and perioperative managements. Although accumulated evidence suggests that many anesthetics and perioperative managements（especially, diabetes and hyperglycemia）modify the above function of K+ channels as a metabolic sensor. Use of effective volatile anesthetics and the strict glycemic control may contribute to protect perioperative vascular function.