Association between anesthetics and autism spectrum disorder: from bench to bedside

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms of impaired social communication and stereotyped behaviors. While early-life exposure to anesthetics may increase the risk of ASD, anesthetics can also have therapeutic effects on ASD, potentially through mechanisms involving the N-methyl-D-aspartate (NMDA) receptor, gamma-aminobutyric acid (GABA)ergic, and µ-opioid receptor signaling pathways. Given that individuals with ASD often exhibit high levels of non-cooperation and poor communication abilities, they typically require deeper sedation during medical examinations, making the choice of anesthetics particularly critical. This article provides an overview about the effects and underlying mechanisms of various anesthetics with ASD, aiming to assist anesthesiologists in implementing anesthesia management for ASD patients more scientifically.