Anesthetics and brain toxicity

Current Opinion in Anaesthesiology
Sulpicio G Soriano, K J S Anand

Abstract

Recent experimental data from rodent studies have demonstrated accelerated neurodegeneration in rat pups exposed to commonly used anesthetic drugs. These provocative findings certainly question and undermine the safe use of anesthetic drugs, particularly in pediatric anesthesia, and have prompted many to investigate the neurotoxic effect of anesthetic drugs on the developing brain. This review will address the scientific evidence for the anesthetic-induced neurotoxicity and its applicability in humans. Several investigators have shown that prolonged administration of anesthetic drugs, including ketamine, isoflurane, nitrous oxide and midazolam, produced increased neurodegeneration in 7-day-old rat pups. The combination of the latter three drugs led to altered learning behavior in adulthood. Despite these unequivocal findings in rodents, similar changes cannot be reproduced in other species. Furthermore, withholding anesthesia during painful procedures in neonatal rats resulted in significant long-term aberrant responses to sensory stimulation and pain thresholds. Taken together, these studies question the applicability of these data to the anesthetic management of the neonate. Further investigations in this area are needed befo...Continue Reading

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Citations

Feb 6, 2015·Oxidative Medicine and Cellular Longevity·Marco SifringerStefanie Endesfelder
Jun 28, 2011·Pediatrics and Neonatology·Maria SammartinoPatrizia Papacci
Oct 14, 2009·Neurotoxicology·Mary Ellen McCannSulpicio G Soriano
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