Xenon: An element of protection

SummaryXenon anaesthesia provides the opportunity to deliver safer surgery to patients with pre-existing organ impairment. The organs at risk in the peri-operative phase include the heart, brain and kidneys. In comparison with other anaesthetic agents, xenon is associated with rapid onset and offset as well as minimal cardiovascular depression. Current evidence suggests that xenon offers the important additional advantage of protecting vulnerable organs against the effects of tissue hypoxia and reperfusion injury. Although volatile anaesthetic agents confer a degree of cardio-protection, the benefits of xenon are much more pronounced and it is likely that the cardio-protective effects of xenon may extend into the post-operative period. Low concentrations of xenon appear to be neuro-protective, even when administered after an ischaemic event. Current trials in neonatal cerebral hypoxic injury show promising results. In vitro evidence is emerging that suggests that xenon may be reno-protective; a tantalizing observation in relation to organ transplantation. The putative cellular mechanisms are discussed in this review. Xenon may, indeed, be the element of protection and further clinical research is a priority.