Neurotoxic Impact of Individual Anesthetic Agents on the Developing Brain

• Type of Material: Article
• Authors: Dabin Ji, Emory University; Joelle Karlik, Emory University
• Language: English
• Date: 2022-11-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/children9111779
• Title of Journal or Parent Work: CHILDREN-BASEL
• Volume: 9
• Issue: 11
• Grant/Funding Information: This research received no external funding.
• Keywords: GENERAL-ANESTHESIA; EARLY EXPOSURE; xenon; Science & Technology; DEXMEDETOMIDINE; Life Sciences & Biomedicine; propofol; pediatric anesthesia; dexmedetomidine; MOLECULAR-MECHANISMS; INFANCY GAS; ketamine; BEHAVIORAL OUTCOMES; Pediatrics; volatile anesthetics; neurotoxicity; neurodevelopment; neonatal anesthesia; INCOMPLETE CEREBRAL-ISCHEMIA; NEURONAL APOPTOSIS; INDUCED APOPTOSIS; AWAKE-REGIONAL ANESTHESIA; thiopental; benzodiazepines
• Research Categories: Biology, Neuroscience; Health Sciences, Medicine and Surgery; Health Sciences, Human Development

Abstract

Concerns about the safety of anesthetic agents in children arose after animal studies revealed disruptions in neurodevelopment after exposure to commonly used anesthetic drugs. These animal studies revealed that volatile inhalational agents, propofol, ketamine, and thiopental may have detrimental effects on neurodevelopment and cognitive function, but dexmedetomidine and xenon have been shown to have neuroprotective properties. The neurocognitive effects of benzodiazepines have not been extensively studied, so their effects on neurodevelopment are undetermined. However, experimental animal models may not truly represent the pathophysiological processes in children. Multiple landmark studies, including the MASK, PANDA, and GAS studies have provided reassurance that brief exposure to anesthesia is not associated with adverse neurocognitive outcomes in infants and children, regardless of the type of anesthetic agent used.