Update on developmental anesthesia neurotoxicity

@article{Vutskits2017UpdateOD,
  title={Update on developmental anesthesia neurotoxicity},
  author={Laszlo Vutskits and Andrew J Davidson},
  journal={Current Opinion in Anaesthesiology},
  year={2017},
  volume={30},
  pages={337–342}
}
Purpose of review Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field. Recent findings Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions… Expand
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Maternal sciatic nerve administered bupivacaine induces hippocampal cell apoptosis in offspring
TLDR
The data suggest that maternal bupivacaine use increases fetal hippocampal cell apoptosis markers such as caspase 8 and cleaved caspases 3, at least in part, via inhibiting the Akt activation. Expand
Sevoflurane Induces Hippocampal Neuronal Apoptosis by Altering the Level of Neuropeptide Y in Neonatal Rats
TLDR
Results showed that sevoflurane caused a significant decrease in NPY expression, whereas exogenous NPY supplementation could reduce sev of lurane-induced hippocampal neuronal apoptosis both in vivo and in vitro. Expand
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References

SHOWING 1-10 OF 27 REFERENCES
Clinical Research Into Anesthetic Neurotoxicity: Does Anesthesia Cause Neurological Abnormalities in Humans?
TLDR
The current state of clinical research into the effects of anesthetic exposure in human brain development is summarized, some of the difficulties in examining the phenomenon are addressed, and the most recent clinical findings presented at the PANDA symposium are introduced. Expand
Isoflurane Anesthesia Has Long-term Consequences on Motor and Behavioral Development in Infant Rhesus Macaques
TLDR
Neonatal exposure to isoflurane, particularly when repeated, has long-term behavioral consequences affecting both motor and socioemotional aspects of behavior. Expand
Lasting impact of general anaesthesia on the brain: mechanisms and relevance
TLDR
Available mechanistic data linking general-anaesthesia exposure to impaired cognitive performance in both young and mature nervous systems are reviewed, providing a critical appraisal of the translational value of animal models. Expand
Current Clinical Evidence on the Effect of General Anesthesia on Neurodevelopment in Children: An Updated Systematic Review with Meta-Regression
TLDR
The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Expand
Comparative Analysis of Outcome Measures Used in Examining Neurodevelopmental Effects of Early Childhood Anesthesia Exposure
TLDR
Exposure to anesthesia in children younger than 3 yr of age and three types of outcomes at age of 10 yr: neuropsychological testing, International Classification of Diseases, 9th Revision, Clinical Modification–coded clinical disorders, and academic achievement showed an increased risk of deficit in exposed children compared with that in unexposed children, whereas academic achievement scores did not. Expand
Association of Anesthesia and Surgery During Childhood With Long-term Academic Performance
TLDR
Exposure to anesthesia and surgery before age 4 years has a small association with later academic performance or cognitive performance in adolescence on a population level, and the low overall difference in academic performance after childhood exposure to surgery is reassuring. Expand
Long-term Effects of Single or Multiple Neonatal Sevoflurane Exposures on Rat Hippocampal Ultrastructure
TLDR
A “threshold effect” for general anesthetic–induced neurotoxicity is suggested, whereby even brief exposures induce long-lasting alterations in neuronal circuitry and sensitize surviving synapses to subsequent loss. Expand
Multiple Anesthetic Exposure in Infant Monkeys Alters Emotional Reactivity to an Acute Stressor
TLDR
Increased emotional behavior in monkeys after anesthesia exposure in infancy may reflect long-term adverse effects of anesthesia, and is addressed in a highly translationally relevant rhesus monkey model. Expand
Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS)
TLDR
Slightly less than 1 h of general anaesthesia in early infancy does not alter neurodevelopmental outcome at age 5 years compared with awake-regional anaesthetic in a predominantly male study population. Expand
Early Exposure to General Anesthesia with Isoflurane Downregulates Inhibitory Synaptic Neurotransmission in the Rat Thalamus
TLDR
In vitro patch-clamp recordings of evoked inhibitory postsynaptic currents from intact neurons of the nucleus reticularis thalami in rat pups exposed at age of P7 are used to hypothesize that changes in inhibitory synaptic transmission in the thalamus induced by GAs may contribute to altered neuronal excitability and consequently abnormal thalamocortical oscillations later in life. Expand
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