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Neurotoxic Impact of Individual Anesthetic Agents on the Developing Brain

Dabin Ji1, Joelle Karlik1

  • 1Department of Anesthesiology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.

Children (Basel, Switzerland)
|November 24, 2022
PubMed

Insights

Concerns about anesthetic safety in children are eased by landmark studies. Brief exposure to anesthesia, regardless of agent type, does not appear to harm neurocognitive outcomes in infants and children.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Toxicology
  • Pediatric Neurology

Background:

  • Animal studies suggested anesthetic agents may harm pediatric neurodevelopment.
  • Concerns existed regarding volatile inhalational agents, propofol, ketamine, and thiopental.
  • Dexmedetomidine and xenon showed potential neuroprotective effects in animal models.

Purpose of the Study:

  • To evaluate the neurocognitive safety of anesthetic agents in children.
  • To address concerns raised by animal studies on anesthetic neurodevelopmental effects.
  • To determine if anesthetic exposure impacts pediatric cognitive function.

Main Methods:

  • Analysis of data from landmark pediatric anesthesia studies (e.g., MASK, PANDA, GAS).
  • Review of animal models investigating anesthetic neurotoxicity.
  • Assessment of neurocognitive outcomes following anesthesia in infants and children.

Main Results:

  • Landmark studies (MASK, PANDA, GAS) indicate brief anesthesia exposure is not linked to adverse neurocognitive outcomes.
  • Animal models may not accurately reflect human pediatric neurodevelopmental responses to anesthesia.
  • The neurocognitive effects of benzodiazepines remain undetermined.

Conclusions:

  • Current evidence from major human studies reassures that brief anesthetic exposure is safe for pediatric neurodevelopment.
  • Animal study findings on anesthetic neurotoxicity should be interpreted cautiously in the context of human pediatric anesthesia.
  • Further research may be needed to fully understand the long-term neurocognitive effects of specific anesthetic agents in children.

Keywords:
benzodiazepinesdexmedetomidineketamineneonatal anesthesianeurodevelopmentneurotoxicitypediatric anesthesiapropofolthiopentalvolatile anestheticsxenon

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