Neonatal Anesthesia and Oxidative Stress

Abstract

Neonatal anesthesia, while often essential for surgeries or imaging procedures, is accompanied by significant risks to redox balance in the brain due to the relatively weak antioxidant system in children. Oxidative stress is characterized by concentrations of reactive oxygen species (ROS) that are elevated beyond what can be accommodated by the antioxidant defense system. In neonatal anesthesia, this has been proposed to be a contributing factor to some of the negative consequences (e.g., learning deficits and behavioral abnormalities) that are associated with early anesthetic exposure. In order to assess the relationship between neonatal anesthesia and oxidative stress, we first review the mechanisms of action of common anesthetic agents, the key pathways that produce the majority of ROS, and the main antioxidants. We then explore the possible immediate, short-term, and long-term pathways of neonatal-anesthesia-induced oxidative stress. We review a large body of literature describing oxidative stress to be evident during and immediately following neonatal anesthesia. Moreover, our review suggests that the short-term pathway has a temporally limited effect on oxidative stress, while the long-term pathway can manifest years later due to the altered development of neurons and neurovascular interactions.

Association of the lncRNA-GAS5 promoter region rs145204276 polymorphism with sevoflurane maintenance anesthesia outcomes on patients undergoing laparoscopic cholecystectomy

“…Both sevoflurane and propofol have been shown to inhibit proinflammatory cytokine release and OSI. 20 - 21 Some investigators have compared the protective effects of sevoflurane and propofol on inflammation and OSI, but the results are contradictory. It is demonstrated that propofol but not sevoflurane prevents OSI in hepatic ischemia/reperfusion injury, 22 while Xie et al 23 illustrated that sevoflurane exerts greater protective effects than propofol on hypoxia-reoxygenation injury in cardiomyocytes.…”

“…Both sevoflurane and propofol have been shown to inhibit proinflammatory cytokine release and OSI. [20][21] Some investigators have compared the protective effects of sevoflurane and propofol on inflammation and OSI, but the results are contradictory.…”

Function and development of interneurons involved in brain tissue oxygen regulation

“…The interference with normal maturation processes early in development may affect NOS interneuron neurovascular interactions to a greater degree, while insults later in development may be more targeted toward VIP- and SST-mediated mechanisms of oxygen regulation. Importantly, these differences in development also point to age-related pathological onset of various psychiatric disorders, such as schizophrenia and anxiety disorders ( Kim-Cohen et al, 2003 ; Dalsgaard et al, 2020 ; Collins and Ninan, 2021 ), as well as the development of learning deficits following neonatal anesthesia exposure ( Gascoigne et al, 2021 , 2022 ). Research in this field is ongoing and will likely be able to address interneuron subtype specific contributions to a range of pathologies.…”

Efficacy of melatonin in alleviating disorders arising from repeated exposure to sevoflurane in males and females of the Wistar rats during preadolescence

“…This age was chosen based on previous literature outlining the timing of adolescence in rodents. Postnatal day (PND [25][26][27][28][29][30] marks the beginning of early adolescence in male and female rats, while PND 60-70 marks the beginning of early adulthood 23,24 . Seventy-two pre-adolescent male and female Wistar rats from eight mothers were randomly assigned to the experimental or control groups.…”