4.7 Review

General anesthetic neurotoxicity in the young: Mechanism and prevention

Journal

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 107, Issue -, Pages 883-896

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2019.10.003

Keywords

Anesthetics; Neurotoxicity; Epigenetics; Herbal compounds; Neuroprotection

Funding

  1. National Natural Science Foundation of China [81401279]
  2. Shanghai Natural Science Foundation [18ZR1443100]
  3. Shanghai Jiao Tong Unviersity School of Medicine, Innovation Center of Translational Medicine Collaboration [TM201729]
  4. Youth Talent Fund of International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine in 2014
  5. Xinchen Foster Fund for Anesthesiologists in Shanghai
  6. MRC
  7. BJA
  8. Royal College of Anaesthetists
  9. NIAA, London, UK

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General anesthesia (GA) is usually considered to safely induce a reversible unconscious state allowing surgery to be performed without pain. A growing number of studies, in particular pre-clinical studies, however, demonstrate that general anesthetics can cause neuronal death and even long-term neurological deficits. Herein, we report our literature review and meta-analysis data of the neurological outcomes after anesthesia in the young. We also review available mechanistic and epigenetic data of GA exposure related to cognitive impairment per se and the potential preventive strategies including natural herbal compounds to attenuate those side effects. In summary, anesthetic-induced neurotoxicity may be treatable and natural herbal compounds and other medications may have great potential for such use but warrants further study before clinical applications can be initiated.

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