Anesthetic Neurotoxicity in Pediatric Patients

Abstract

In recent years, an increasing number of publications have shown the negative efects of anesthetics on the developing brain and have made inquiries about anesthesia for pediatric patients in practice. Anesthesia is applied to millions of children for surgery, imaging, and other invasive procedures; the issue is very serious and concerns. In this chapter, experimental and clinical studies about the issue have been summarized. As a result, anesthetic drugs except alpha-2 adrenergic agonist anesthetic (NMDA antagonist or a GABA agonist) used in pediatric patients (especially if there is no painful situation) have potential neurotoxicity. Particularly, if anesthesia exposure was applied in the fragile period (the irst 4 years) and if used at higher concentrations or repeated anesthesia application, adverse efects of anesthesia exposure on the developing brain have been claimed. But, the issue is not fully clariied yet.

Oxygen saturation profile in traumatic brain injury animal model after propofol administration

“…Propofol possesses neuroprotective effects attributed to its antioxidant activity and ability to decrease brain metabolic rate and it helps redistribute cerebral blood flow, suppress glutamate during ischemic events, and regulate apoptosis-associated proteins [10]. However, its effects on brain tissue following TBI, either neuroprotective or neurotoxic, are not fully understood [11][12][13][14][15]. In addition, apart from its neuroprotective effect, propofol can also cause respiratory depression, bronchospasm, laryngospasm, and apnea [16,17].…”

Effect of ethanol extract of nigella sativa L seeds and propofol on BDNF protein level as neuroplasticity and neuroprotection of traumatic brain injury in rats

“…19 BDNF is useful in reducing the density of propofol synapses followed by activation of growth factor receptors p75NTR and RhoA, namely actin depolymerization, loss of microtubules, and disruption of axon transport resulting in inhibition of BDNF traffic. 20,21 Propofol is an intravenous anesthetic agent used as an anesthetic induction agent and is also widely used to sedate patients in intensive care units. Many preliminary studies suggest that propofol has a neuroprotective effect against brain ischemia.…”