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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

318
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...
318
Stages of General Anesthesia01:22

Stages of General Anesthesia

854
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...
854
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

266
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.
266
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

567
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...
567
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

518
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...
518

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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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Anesthesia and Developing Brains: Unanswered Questions and Proposed Paths Forward.

Caleb Ing1, David O Warner, Lena S Sun2

  • 1Departments of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York; the Department of Anesthesiology, Mailman School of Public Health, Columbia University, New York, New York.

Anesthesiology
|January 11, 2022
PubMed
Summary

Anesthetic exposure in children shows no link to intelligence deficits but may affect behavior. Further research is needed to understand potential neurotoxicity and behavioral outcomes in pediatric patients.

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Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Anesthesiology

Background:

  • Animal models suggest anesthetic agents disrupt neurodevelopment.
  • Human evidence regarding anesthetic neurotoxicity in children is mixed.
  • Identifying a clear phenotype of anesthetic-induced injury in children has been difficult.

Purpose of the Study:

  • To describe expert consensus and disagreement on anesthetic neurotoxicity in children.
  • To summarize preclinical and clinical evidence on anesthetic effects on neurodevelopment.
  • To propose future clinical research directions and compare anesthetic agents to other neurotoxins.

Main Methods:

  • Review of preclinical animal studies and clinical human trials.
  • Analysis of neurodevelopmental outcomes, including intelligence and behavior.
  • Expert opinion synthesis regarding anesthetic neurotoxicity.

Main Results:

  • Brief or single early anesthetic exposure in children is not linked to broad intelligence deficits.
  • Behavioral deficits are more consistently reported in human studies and align with nonhuman primate findings.
  • The concept of anesthetic neurotoxicity in children remains debated.

Conclusions:

  • While broad intelligence appears unaffected by early anesthetic exposure, behavioral outcomes warrant further investigation.
  • Behavioral deficits may represent a key phenotype of anesthetic neurotoxicity in pediatric populations.
  • Continued research is crucial to clarify the long-term neurodevelopmental effects of anesthetics in children.