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General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

Stages of General Anesthesia

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Adverse Effects

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...

Inhalational Anesthetics: Overview

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...

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Updated: May 24, 2026

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Published on: May 12, 2018

Effect of general anesthetics on the developing brain.

S Velayudha Reddy¹

¹Department of Anaesthesiology, Rajiv Gandhi Institute of Medical Sciences, Kadapa, Andhra Pradesh, India.

Journal of Anaesthesiology, Clinical Pharmacology

|February 21, 2012

Summary

General anesthetics may harm the developing brain, causing cell death and long-term issues. Research in animals and humans suggests potential risks, but more study is needed before changing clinical practice for pediatric anesthesia.

Keywords:

Apoptosis delayed effects general anesthetics neurodegeneration

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Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

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Published on: May 12, 2018

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Published on: July 23, 2020

Area of Science:

Neuroscience
Anesthesiology
Developmental Biology

Background:

Studies suggest prolonged exposure to general anesthetics may cause neuronal cell death and neurological issues in developing brains.
Preclinical evidence in rodents and nonhuman primates indicates anesthetics are neurotoxic to the developing brain, causing long-term neurobehavioral abnormalities.
Human cohort studies show an association between neonatal surgery under anesthesia and poor neurodevelopmental outcomes.

Purpose of the Study:

To review recent developments concerning the neurotoxicity of general anesthetics on the developing brain.
To summarize current understanding of anesthesia-induced neuroapoptosis mechanisms.
To explore potential neuroprotective strategies for preventing anesthesia-induced neuronal death in neonates.

Main Methods:

A randomized literature search was conducted using keywords: apoptosis, general anesthetics, and developing brain.
Searches were performed in PUBMED and relevant published literature from 1979 to 2011.
The review synthesizes findings from preclinical animal studies and human cohort studies.

Main Results:

Preclinical data strongly suggest anesthetics are neurotoxic to the developing brain, inducing cell death and long-term neurobehavioral deficits.
Human studies indicate a correlation between neonatal surgery under anesthesia and adverse neurodevelopmental outcomes.
Key components involved in anesthesia-induced neuroapoptosis have been identified.

Conclusions:

Mounting evidence suggests general anesthetics pose a risk to the developing brain, necessitating further investigation.
Neuroprotective strategies may offer potential adjunct therapies for neonatal anesthesia.
Current data are insufficient to recommend changes in clinical practice for pediatric anesthesia.