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Anesthetic neurotoxicity

Jeffrey J Pasternak, William L Lanier
We provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, and anesthetic neurotoxicity.
April 2018: Journal of Neurosurgical Anesthesiology
Jie Gao, Ailin Luo, Jing Yan, Xi Fang, Xiaole Tang, Yilin Zhao, Shiyong Li
Accumulating evidence indicates that general anesthetics can cause acute neuroapoptosis and long-term cognitive deficit in models exposed to anesthetics during the brain growth-spurt period. Anesthetics-induced imbalance of mitochondrial fusion and fission preceded and contributed to developmental neuroapoptosis. Accordingly, the imbalance was accompanied by activation of dynamin-related protein (Drp)1 which was closely associated with synaptic degeneration in neurodegenerative diseases. Based on the neuroprotective role of mitochondrial division inhibitor-1 (mdivi-1) in neurodegeneration and stroke, we set out to examine whether mdivi-1 can mitigate developmental neurotoxicity induced by isoflurane...
2018: American Journal of Translational Research
Sufang Jiang, Xuze Li, Wei Jin, Xiaofeng Duan, Lijun Bo, Jiangli Wu, Rui Zhang, Ying Wang, Rongtian Kang, Lining Huang
Ketamine, a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist, is widely used in pediatric clinical practice. However, prolonged exposure to ketamine results in widespread anesthetic neurotoxicity and long-term neurocognitive deficits. The molecular mechanisms that underlie this important event are poorly understood. We investigated effects of anesthetic ketamine on neuroapoptosis and further explored role of NMDA receptors in ketamine-induced neurotoxicity. Here we demonstrate that ketamine induces activation of cell cycle entry, resulting in cycle-related neuronal apoptosis...
March 1, 2018: Neuroscience Letters
Hitoshi Saito, Rui Kato, Toshikazu Hashimoto, Yosuke Uchida, Tetsutaro Hase, Kenkichi Tsuruga, Koichi Takita, Yuji Morimoto
For several decades, the neurotoxicities of anesthetics to the developing brain have been reported by many researchers focusing on various phenomena such as apoptosis, neurodegeneration, electrophysiological aberrations, and behavioral abnormalities. According to these reports, signals via N-methyl-D-aspartate receptors (NMDA-r) and/or γ-aminobutyric acid type A receptors (GABAA -r) are implicated in the anesthetic neurotoxicity. On the other hand, during brain development, NMDA-r and GABAA -r are also recognized to play primary roles in neural cell migration...
2018: Biomedical Research
Tamara Horváth, Tünde Vezér, Gábor Kozma, András Papp
Background and purpose: Nanoparticles of titanium dioxide are suspected neurotoxic agents and have numerous applications possibly resulting in human exposure by several ways including inhalation. In the present work, rats were exposed to spherical TiO2 nanoparticles of two different sizes by the intratracheal route. It was investigated how the neuro-functional alterations, detected by electrophysiological and behavioral methods, were related to the concentration of Ti in the tissue samples and what the influence of the size of the NPs was...
January 30, 2018: Ideggyógyászati Szemle
Momoka Tonan, Moritoki Egi, Nana Furushima, Satoshi Mizobuchi
Progressive supranuclear palsy (PSP) is one of the rare diseases. PSP is characterized by oculomotor dysfunction, postural instability, akinesia, dysarthria, and dysphagia. The major cause of death in patients with PSP is aspiration pneumonia. Considering these complications, spinal anesthesia is useful in patients with PSP. However, the potential harmful effects of spinal anesthesia including neurotoxicity of local anesthetics and neurologic complications for patients with PSP are unclear, because there has been no report...
2018: JA Clin Rep
Hui Zhao, Meimei Bu, Binglu Li, Yong Zhang
Desfluraneis a widely-used general anesthetics. However, recent reports showed its significant side effect in the nervous system. Desflurane could lead to the neuronal death and affect the working memory. Unfortunately, the mechanism underlying the action of desflurane is still not clear and there is still no potent medicine to prevent the lesion in the central nervous system caused by general anesthetics. In this study, we found α-lipoic acid, an antioxidant exerting protective effect on multiple cells tissues, could resist the neurotoxicity caused by desflurane exposure...
February 2018: Tissue & Cell
Beverley A Orser, Santhanam Suresh, Alex S Evers
SmartTots ( represents a public-private partnership between the International Anesthesia Research Society and the US Food and Drug Administration. Over the past 7 years, SmartTots has worked in collaboration with various stakeholders to determine whether anesthetic drugs have detrimental effects on the developing brain. SmartTots has funded clinical and preclinical studies, organized meetings, served as a repository of peer-reviewed information, and facilitated the development of consensus-based statements...
February 2, 2018: Anesthesia and Analgesia
Hongli Kan, Yang Wang, Dongxin Wang, Hong Sun, Shu Zhou, Huaiwu Wang, Jian Guan, Ming Li
Application of local anesthetic reagents, such as lidocaine (Lid), could cause significant neurotoxicity in spinal cord dorsal root ganglia neurons (DRGNs). In this study, we investigated the potential rescuing effect of cordycepin (CDC) in an in vitro explant model of lidocaine-induced apoptosis in DRGNs. Explant of rat neonatal DRGNs was prepared, and treated with Lid in vitro to induce neuronal apoptosis. Prior to Lid treatment, DRGN explant was pre-incubated with various concentrations of CDC to evaluate its rescuing effect on Lid-induced apoptosis...
January 27, 2018: European Journal of Pharmacology
Jian-Yue Wang, Yong Feng, Yan-Hong Fu, Guang-Li Liu
Postoperative cognitive dysfunction in elderly patients has been related to neurodegenerative disorders and mortality. Sevoflurane anesthesia has been implicated in both postoperative cognitive dysfunction and neurotoxicity. Given the advantages of using inhaled anesthetics like sevoflurane, it is important to understand how their usage results in neurotoxicity and subsequently devise ways to circumvent or attenuate the anesthetic-mediated induction in neurotoxicity. Long noncoding RNAs (LncRNAs) are a group of > 200 bp long RNAs and show specific spatiotemporal expression profiles...
January 19, 2018: Journal of Molecular Neuroscience: MN
Robert J Tamai, Brian T Sullivan, Rushyuan J Lee
BACKGROUND: Peripheral nerve blocks (PNBs) provide excellent pain control and reduce the need for systemic analgesics in orthopaedic surgery. PNBs rarely cause complications; however, a few studies of adults have reported neurological complications during the early postoperative period. We investigated complications associated with the use of PNBs during pediatric knee surgery. METHODS: We reviewed the medical records of all 121 children (aged ≤18 y) who underwent knee surgery by 1 orthopaedic surgeon between October 2014 and September 2016...
March 2018: Journal of Pediatric Orthopedics
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
Jun Liang Yuan, Shuang Kun Wang, Tao Jiang, Wen Li Hu
BACKGROUND: Nitrous oxide (N2O), a long-standing anesthetic, is also neurotoxic by interfering with the bioavailability of vitamin B12 if abused. A few case studies have reported the neurological and psychiatric complications of N2O. CASE PRESENTATION: Here, we reported a patient of N2O induced subacute combined degeneration (SCD) with longitudinally extensive myelopathy with inverted V-sign exhibiting progressive limb paresthesia and unsteady gait. CONCLUSIONS: This case raises the awareness of an important mechanism of neural toxicity of N2O, and clinical physicians should be well recognized this in the field of substance-related disorders...
December 28, 2017: BMC Neurology
Rui Xiao, Dan Yu, Xin Li, Jing Huang, Sheng Jing, Xiaohang Bao, Tiande Yang, Xiaotang Fan
Propofol is a widely used anesthetic in the clinic while several studies have demonstrated that propofol exposure may cause neurotoxicity in the developing brain. However, the effects of early propofol exposure on cerebellar development are not well understood. Propofol (30 or 60 mg/kg) was administered to mice on postnatal day (P)7; Purkinje cell dendritogenesis and Bergmann glial cell development were evaluated on P8, and granule neuron migration was analyzed on P10. The results indicated that exposure to propofol on P7 resulted in a significant reduction in calbindin-labeled Purkinje cells and their dendrite length...
2017: Frontiers in Cellular Neuroscience
Fangfang Zhang, Shiping Wang, Chen Lv, Mei Zhang, Liuying Yang, Xiaowen Guo
Ketamine, a commonly used anesthetic compound, may cause neurotoxicity in immature or developing brains. In this study, we indented to understand the molecular expression and functional role of Lin-28 Homolog B (lin28b) in regulating ketamine-induced neurotoxicity in neural stem cells (NSCs)-differentiated neurons. NSCs from embryonic rat brains were cultured in vitro, and induced toward neuronal differentiation. NSCs-differentiated neurons were treated with various concentrations of ketamine for 24h to evaluate the concentration-dependent effect of ketamine on endogenous lin28b mRNA level...
December 12, 2017: European Journal of Pharmacology
Xin Zhang, Qing Yang, Zhi Zhang
OBJECTIVE: This meta-analysis aimed to compare the efficiency and safety of local liposomal bupivacaine infiltration and traditional cocktail analgesia for pain management in total hip arthroplasty (THA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. INCLUSION CRITERIA: Participants: patients planned for a THA with a diagnosis of hip osteoarthritis. INTERVENTIONS: liposomal bupivacaine was administrated in the experimental groups for pain control...
December 2017: Medicine (Baltimore)
Bonnie L Robinson, Melanie Dumas, Syed F Ali, Merle G Paule, Qiang Gu, Jyotshna Kanungo
Ketamine, a phencyclidine derivative, is an antagonist of the Ca2+ -permeable N-methyl-d-aspartate (NMDA)-type glutamate receptors. It is a pediatric anesthetic and has been implicated in developmental neurotoxicity. Ketamine has also been shown to deplete ATP in mammalian cells. Our previous studies showed that acetyl l-carnitine (ALCAR) prevented ketamine-induced cardiotoxicity and neurotoxicity in zebrafish embryos. Based on our finding that ALCAR's protective effect was blunted by oligomycin A, an inhibitor of ATP synthase, we further investigated the effects of ketamine and ALCAR on ATP levels, mitochondria and ATP synthase in zebrafish embryos...
December 7, 2017: Neurotoxicology and Teratology
Zeyong Yang, Jingjing Lv, Xianfu Lu, Xingxing Li, Xiaohu An, Jianwei Wang, Hao Weng, Yuanhai Li
A large number of studies have demonstrated that inhalation anesthetic isoflurane induced neural cell death by apoptosis in various cell and animal models. Emulsified isoflurane (EIso) is a new type of intravenous preparation of isoflurane that attracts increasing research attention as a promising clinical agent due to its both advantages as an intravenous and inhalation anesthetics medication. However, its safety and underlying molecular mechanism of neurotoxicity largely remain unknown. Therefore, it is meaningful to investigate the safety of EIso and to further elucidate its mechanism of anesthetic neurotoxicity...
January 2018: Neurotoxicology and Teratology
Jingjing Zhang, Changlei Cui, Yanhui Li, Haiyang Xu
Clinical application of anesthetic reagent, ketamine (Keta), may induce irreversible neurotoxicity in central nervous system. In this work, we utilized an in vitro model of neural stem cells-derived neurons (nSCNs) to evaluate the role of GSK-3 signaling pathway in Keta-induced neurotoxicity. Embryonic mouse-brain neural stem cells were differentiated into neurons in vitro. Keta (50 μM)-induced neurotoxicity in cultured nSCNs was monitored by apoptosis, immunohistochemical and western blot assays, respectively...
March 2018: Neuromolecular Medicine
Xiaoli Liang, Yi Zhang, Chao Zhang, Chunchun Tang, Yi Wang, Juanjuan Ren, Xi Chen, Yu Zhang, Zhaoqiong Zhu
Currently sevoflurane is the volatile anesthetic most wildly used in pediatric surgery. Whether neonatal exposure to sevoflurane brings about a long-lasting adverse impact even at juvenile and adult age, attracts extensive concerns. However, to date the consensus has not been reached and how exposure to sevoflurane in early life affects long-term ability of learning and memory is not fully elucidated. To obtain further insight into this issue, 32 neonatal SD rats were assigned into control group (group C, n=16) and sevoflurane group (group SEV, n=16)...
2017: American Journal of Translational Research
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