Chapter 5 - Anesthetic drugs and the developing fetal brain

Summary

Over the last decade there has been an explosion of literature published on the neuroapoptosis induced by anesthetic drugs in animals and the potential impact this may have on fetuses, neonates, and infants. The period of brain growth when synaptic differentiation occurs, also called synaptogenesis, occurs from the sixth month of gestation to 24 months after birth in humans. The teratogenicity of a substance is multifactorial and includes species susceptibility, dose, duration and timing of exposure, and genetic predisposition. Anesthetics have been shown to cause apoptosis in numerous cell types as well as cause neurotoxicity in a concentration- and time-dependent manner in in-vitro and in-vivo models, and mechanisms have been proposed based on the receptor activity of the anesthetic agents. In an extensive review on the effects of general anesthetics on developing brain structure and neurocognitive function, the evidence for individual anesthetic agents causing neurodegeneration and functional impairment was discussed.