Neurotoxicity of anesthetic drugs

Bilotta, Federico; Evered, Lis; Gruenbaum, Shaun E.

doi:10.1097/aco.0000000000000482

Cited by 41 publications

(20 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…That study was based on a short follow up (10 days) and doesn't say anything about long term cognitive deficits, but the results reinforced the possibility that inhalation anaesthetics may play a part in the development of dementia [17][18][19] . Possible mechanisms have been put forward suggesting that inhalational anaesthetics may be neurotoxic and contribute to POCD 26 . An explanation for the acceleration of Alzheimer's neuropathology by inhaled anaesthetic agents include increased amyloid β oligomerisation and tau phosphorylation and aggregation, as suggested by experimental research on mice 6,18 .…”

Section: Discussionmentioning

confidence: 99%

Is there a relationship between anaesthesia and dementia?

Strand

Nyqvist

Ekdahl

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background Long-term cognitive problems are common among elderly patients after surgery, and it has been suggested that inhalation anaesthetics play a role in the development of dementia. This study aims to investigate the hypothesis that patients with dementia have been more exposed to surgery and inhalational anaesthetics than individuals without dementia. Methods Using 457 cases from a dementia-registry and 420 dementia-free controls, we performed a retrospective case-control study. The medical records were reviewed to determine exposure to anaesthesia occurring within a 20-year timeframe before the diagnosis or inclusion in the study. Data were analysed using multivariate logistic regression and propensity score analysis. Results Advanced age (70 years and older, with the highest risk in ages 80 to 84 years) and previous head trauma were risk factors for dementia. History of exposure to surgery with anaesthesia was a risk factor for dementia (OR = 2.23, 95% CI 1.66-3.00, P < 0.01). Exposure to inhalational anaesthetics with halogenated anaesthetics was associated with an increased risk of dementia, compared to no exposure to anaesthesia (OR = 2.47, 95% CI 1.17-5.22, P = 0.02). Exposure to regional anaesthesia was not significantly associated with increased risk of dementia (P=0.13). Conclusion In this 20-year retrospective case-control study, we found a potential association between dementia and prior anaesthesia. Exposure to general anaesthetics with halogenated anaesthetic gases was associated with an increased risk of dementia.

show abstract

Section: Discussionmentioning

confidence: 99%

Is there a relationship between anaesthesia and dementia?

Strand

Nyqvist

Ekdahl

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Just as animal studies demonstrate that exposure to anesthetic agents leads to injury to cells in the developing brain, preclinical studies suggest that these compounds may also have detrimental effects on aging brains (Bilotta et al 2017;Brambrink et al 2012b;Jevtovic-Todorovic et al 2013). Anesthetic neurotoxicity and subsequent changes in neurocognition may occur in both young and elderly brains, and it is possible that the mechanisms of action may be similar (Armstrong et al 2017;Jevtovic-Todorovic et al 2013).…”

Section: Clinical Evidence For Anesthetic Neurotoxicity In the Aging mentioning

confidence: 99%

Anesthetics: from modes of action to unconsciousness and neurotoxicity

Iqbal

Thompson

Riaz

et al. 2019

Journal of Neurophysiology

View full text Add to dashboard Cite

Modern anesthetic compounds and advanced monitoring tools have revolutionized the field of medicine, allowing for complex surgical procedures to occur safely and effectively. Faster induction times and quicker recovery periods of current anesthetic agents have also helped reduce health care costs significantly. Moreover, extensive research has allowed for a better understanding of anesthetic modes of action, thus facilitating the development of more effective and safer compounds. Notwithstanding the realization that anesthetics are a prerequisite to all surgical procedures, evidence is emerging to support the notion that exposure of the developing brain to certain anesthetics may impact future brain development and function. Whereas the data in support of this postulate from human studies is equivocal, the vast majority of animal research strongly suggests that anesthetics are indeed cytotoxic at multiple brain structure and function levels. In this review, we first highlight various modes of anesthetic action and then debate the evidence of harm from both basic science and clinical studies perspectives. We present evidence from animal and human studies vis-à-vis the possible detrimental effects of anesthetic agents on both the young developing and the elderly aging brain while discussing potential ways to mitigate these effects. We hope that this review will, on the one hand, invoke debate vis-à-vis the evidence of anesthetic harm in young children and the elderly, and on the other hand, incentivize the search for better and less toxic anesthetic compounds.

show abstract

“…It also highlights the value of CEUS in reducing the number of MRI scans and associated sedation, which has been associated with neurotoxic effects in the developing brain. 10,11 Additionally, magnetic resonance contrast administration is posing a challenge because of the gadolinium accumulation in the body. Further benign CEUS enhancement characteristics include well-defined peripheral and/or central vascular pattern (ie, benign lymph nodes, hyperplastic thyroid nodules, focal nodular hyperplasia, and splenic hamartoma), delayed wash out (ie, liver regenerative nodules), and lack of enhancement (ie, hemorrhage, cyst, column of Bertin, and calyceal diverticulum).…”

Section: Benign Focal Parenchymal Lesionsmentioning

confidence: 99%

Advanced Ultrasound Techniques for Pediatric Imaging

2019

View full text Add to dashboard Cite

Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen tremendously. Advanced ultrasound techniques constitute a suite of new technologies that employ microbubbles to provide contrast and enhance flow visualization, elastography to measure tissue stiffness, ultrafast Doppler to deliver high spatiotemporal resolution of flow, three-and four-dimensional technique to generate accurate spatiotemporal representation of anatomy, and high-frequency imaging to delineate anatomic structures at a resolution down to 30 mm. Application of these techniques can enhance the diagnosis of organ injury, viable tumor, and vascular pathologies at bedside. This has significant clinical implications in pediatric patients who are not easy candidates for lengthy MRI or radiation-requiring examination, and are also in need of a highly sensitive bedside technique for therapeutic guidance. To best use the currently available, advanced ultrasound techniques for pediatric patients, it is necessary to understand the diagnostic utility of each technique. In this review, we will educate the readers of emerging ultrasound techniques and their respective clinical applications.

show abstract

Neurotoxicity of anesthetic drugs

Cited by 41 publications

References 41 publications

Is there a relationship between anaesthesia and dementia?

Is there a relationship between anaesthesia and dementia?

Anesthetics: from modes of action to unconsciousness and neurotoxicity

Advanced Ultrasound Techniques for Pediatric Imaging

Contact Info

Product

Resources

About