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A hipotensão é uma condição crítica em pacientes com trauma crânioencefálico (TCE), frequentemente associada a complicações e piora do prognóstico. Este estudo revisa intervenções anestésicas para controle hemodinâmico e neuroproteção em TCE, com foco em bloqueadores adrenérgicos, prostaciclina, gases inalatórios e sedativos. O uso de bloqueadores adrenérgicos, como propranolol e clonidina, demonstrou benefícios na modulação simpática e redução da hiperatividade, embora a eficácia plena necessite de mais estudos. A prostaciclina mostrou efeitos na estabilização da microcirculação cerebral e na redução da permeabilidade vascular. Gases inalatórios, como oxigênio hiperbárico, demonstraram potencial para melhorar a perfusão cerebral e reduzir o edema cerebral. A dexmedetomidina, com suas propriedades de redução do estresse simpático, também foi associada a melhorias na pressão de perfusão cerebral. O monitoramento invasivo e o uso de biomarcadores, como o glicerol, podem ajudar na personalização do tratamento. Apesar dos avanços, mais pesquisas clínicas são necessárias para consolidar essas terapias no manejo de TCE.
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