Abstract:

With the advent of modern techniques, drugs, and monitoring, general anesthesia has come to be considered an unlikely cause of harm, particularly for healthy patients. While this is largely true, newly emerging clinical and laboratory studies have suggested that exposure to anesthetic agents during early childhood may have long-lasting adverse effects on cognitive function. The evidence strongly suggests that glia are a possible target of anesthetic toxicity. Astrocytes clearly undergo cytoskeletal disruption as a result of early anesthetic exposure and their capacity to support neuronal growth is transiently impaired. These results have been obtained using dissociated culture models, and must still be translated to the context of the intact brain. Anesthetics induce apoptotic cell death in a substantial population of oligodendrocytes in the developing brain, but the significance of this finding will be greatly enhanced if it is shown to be persistent. The currently available literature on the effects of anesthetics on glia in the developing brain is fairly sparse compared to studies of developmental anesthetic toxicity in neurons, and we conclude that this is a promising area for further study in the field of pediatric anesthetic neurotoxicity.