Anesthetics and sedatives: Toxic or protective for the developing brain?

Despite our insufficient understanding of the exact molecular mechanisms of general anesthetics and sedatives, every year millions of children are treated with these drugs in a seemingly safe manner. However, increasing evidence particularly from animal studies has suggested the possibility for dele...

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Bibliographic Details
Published in:Pharmacological research 2012-03, Vol.65 (3), p.271-274
Main Authors: Ward, Christopher G., Loepke, Andreas W.
Format: Article
Language:English
Subjects:
Anesthesia
Anesthetics
Anesthetics - pharmacology
Anesthetics - toxicity
Animal
Animals
Brain
Brain - drug effects
Brain - growth & development
Disability
GABA
Humans
Hypnotics and Sedatives - pharmacology
Hypnotics and Sedatives - toxicity
Learning impairment
Neonate
Neuroapoptosis
Neurodegeneration
Neuroprotection
Neurotoxicity
Neurotoxicity Syndromes - etiology
NMDA
Opioids
Pain
Pediatric
Sedation
Surgery
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Summary:Despite our insufficient understanding of the exact molecular mechanisms of general anesthetics and sedatives, every year millions of children are treated with these drugs in a seemingly safe manner. However, increasing evidence particularly from animal studies has suggested the possibility for deleterious effects in pediatric patients. All currently clinically utilized anesthetic drugs have been found to induce neuronal cell death in the developing brain and to potentially cause long-term neurological impairment. Conversely, painful stimuli without analgesia and anesthesia have also been shown to initiate a harmful stress response in young children and to trigger neurotoxic effects in the developing brain, which can be blunted by anesthetics. Moreover, anesthetic drugs may also confer neurological protection during hypoxic and ischemic insults. The mechanisms and human applicability of anesthetic neurotoxicity and neuroprotection remain under intense investigation and this Perspectives article summarizes the current state of research.
ISSN:1043-6618
1096-1186
DOI:10.1016/j.phrs.2011.10.001