title: [Neurotoxicity of general anesthetics in childhood: does anesthesia leave its mark on premature babies, newborns and infants?].
abstract: Many animal experiments have shown that anesthetics can have a neurotoxic effect on immature brains because they induce apoptosis and influence neurogenesis and synaptogenesis. In animal experiments this has substantial implications for the neurocognitive functions of animals in later life. Whether these results of animal experiments can be transferred to humans is currently the subject of intensive research. In several retrospective studies no clear association between anesthesia in premature babies, newborns or infants and the occurrence of learning disorders or behavioral problems could be found. The prospective studies GAS and PANDA are designed to obtain a deeper insight and if possible to clarify this problem. Because of the high relevance of this topic and in order to achieve more clarity for this problem when dealing with parents, the scientific working group for neuroanesthesia and pediatric anesthesia of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) has formulated a position document on the basis of currently available data.
authors: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Deutschland. barbara.sinner@klinik.uni-regensburg.de
authors: B
authors: B
authors: Sinner
authors: K
authors: K
authors: Becke
authors: K
authors: K
authors: Engelhard
mesh_terms: D018681:Anesthetics, General / Q000009:adverse effects* / Q000494:pharmacology / Q000633:toxicity; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009410:Nerve Degeneration / Q000139:chemically induced / Q000473:pathology; D009474:Neurons / Q000187:drug effects; D018696:Neuroprotective Agents / Q000494:pharmacology; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000503:physiopathology*
chemical_list: D018681:Anesthetics, General; D004338:Drug Combinations; D018696:Neuroprotective Agents
references: J Neurosci Res. 1996 Sep 01;45(5):631-6
references: 8875327
references: J Neurosurg Anesthesiol. 2008 Jan;20(1):21-8
references: 18157021
references: Crit Care Med. 1994 Jun;22(6):1032-4
references: 8205811
references: Early Hum Dev. 1978 Apr;2(1):81-7
references: 569046
references: Twin Res Hum Genet. 2009 Jun;12(3):246-53
references: 19456216
references: Anesthesiology. 2011 Mar;114(3):578-87
references: 21293251
references: Acta Paediatr Suppl. 1997 Jul;422:27-33
references: 9298788
references: Physiol Behav. 1999 Jun;66(4):627-37
references: 10386907
references: Ann Pharmacother. 2006 Jun;40(6):1035-9
references: 16720707
references: Anesthesiology. 2005 Apr;102(4):720-6
references: 15791099
references: Paediatr Anaesth. 1996;6(3):201-7
references: 8732611
references: Anaesthesia. 1997 Oct;52(10):970-6
references: 9370839
references: Epilepsy Behav. 2007 Nov;11(3):270-6
references: 17996634
references: Toxicology. 2007 May 20;234(3):216-26
references: 17418473
references: Ann Emerg Med. 1999 Oct;34(4 Pt 1):492-7
references: 10499950
references: Exp Neurol. 1985 Sep;89(3):503-19
references: 4029332
references: Anesth Analg. 1993 Mar;76(3):520-6
references: 8452259
references: Anesthesiology. 2010 Mar;112(3):546-56
references: 20124985
references: Acta Paediatr. 2000 May;89(5):533-41
references: 10852187
references: Science. 2000 Jul 28;289(5479):628-31
references: 10915627
references: Anesthesiology. 2011 May;114(5):1076-85
references: 21368654
references: Anesthesiology. 2000 May;92(5):1408-17
references: 10781288
references: Toxicol Sci. 2007 Jul;98(1):145-58
references: 17426105
references: Behav Brain Res. 2004 Aug 31;153(2):367-76
references: 15265631
references: Lancet. 1997 Mar 1;349(9052):599-603
references: 9057731
references: Brain Res. 1988 Jun 1;469(1-2):209-19
references: 3401798
references: Paediatr Anaesth. 2004 Oct;14(10):866-70
references: 15385017
references: J Pediatr. 1991 Oct;119(4):644-9
references: 1919899
references: Anesthesiology. 2011 Aug;115(2):282-93
references: 21701379
references: Toxicol Sci. 2006 Jun;91(2):540-9
references: 16581949
references: Anesthesiology. 2009 May;110(5):1077-85
references: 19352168
references: Acta Anaesthesiol Scand. 1977;21(6):541-4
references: 605770
references: Sci Am. 1979 Sep;241(3):113-33
references: 493917
references: Neuropediatrics. 1992 Apr;23(2):60-7
references: 1351263
references: Anesthesiology. 2009 Aug;111(2):302-10
references: 19602960
references: Intensive Crit Care Nurs. 2004 Dec;20(6):344-51
references: 15567675
references: Anesthesiology. 2005 May;102(5):970-6
references: 15851884
references: Can J Anaesth. 2006 Nov;53(11):1078
references: 27771906
references: Anaesthesia. 1992 Sep;47(9):811
references: 1415984
references: Anesth Analg. 1999 May;88(5):1042-7
references: 10320165
references: Early Hum Dev. 1979 Mar;3(1):79-83
references: 118862
references: Anesthesiology. 2012 Feb;116(2):372-84
references: 22222480
references: Int J Dev Neurosci. 2009 Nov;27(7):727-31
references: 19580862
references: Front Pharmacol. 2012 Mar 29;3:46
references: 22479246
references: Curr Opin Anaesthesiol. 2007 Aug;20(4):300-6
references: 17620835
references: J Crit Care. 2004 Sep;19(3):174-8
references: 15484178
references: Proc West Pharmacol Soc. 2009;52:109-11
references: 22128436
references: Paediatr Anaesth. 2006 Aug;16(8):846-59
references: 16884468
references: J Neurosurg Anesthesiol. 2009 Oct;21(4):286-91
references: 19955889
references: J Appl Toxicol. 2007 May-Jun;27(3):201-17
references: 17265419
references: Prog Brain Res. 2005;147:231-48
references: 15581710
references: Neurotoxicol Teratol. 2011 Mar-Apr;33(2):220-30
references: 21241795
references: J Basic Clin Physiol Pharmacol. 2005;16(4):231-43
references: 16438390
references: South Med J. 1995 Mar;88(3):290-4
references: 7886524
references: Science. 1974 Aug 16;185(4151):625-7
references: 4841573
references: Acta Paediatr. 1994 Nov;83(11):1194-9
references: 7841736
references: Anesthesiology. 2010 Mar;112(3):567-75
references: 20124973
references: Anesthesiology. 2009 Apr;110(4):813-25
references: 19293698
references: Anesthesiology. 2012 Feb;116(2):352-61
references: 22198221
references: Curr Drug Targets CNS Neurol Disord. 2004 Aug;3(4):297-313
references: 15379606
references: Anesthesiology. 2009 Apr;110(4):849-61
references: 19293696
references: Acta Paediatr. 1993 Oct;82(10):885-6
references: 8241654
references: Anesthesiology. 2011 Nov;115(5):979-91
references: 21956042
references: Anesth Analg. 2011 Nov;113(5):1161-9
references: 21788311
references: Science. 1997 Sep 12;277(5332):1659-62
references: 9287218
references: Neurobiol Dis. 2006 Mar;21(3):522-30
references: 16289675
references: Anesthesiology. 2007 Apr;106(4):746-53
references: 17413912
references: PLoS One. 2009 Sep 16;4(9):e7043
references: 19756154
references: Paediatr Anaesth. 2005 Apr;15(4):266-74
references: 15787916
references: Toxicol Sci. 2004 Oct;81(2):364-70
references: 15254342
references: Anesth Analg. 2011 Nov;113(5):1152-60
references: 21918167
references: J Comp Neurol. 1994 Feb 15;340(3):328-36
references: 8188854
references: Toxicology. 2008 Jul 30;249(2-3):153-9
references: 18550250
references: N Engl J Med. 1990 Feb 8;322(6):364-9
references: 2242106
references: Epilepsy Res. 2010 Jan;88(1):11-22
references: 19825509
references: Nature. 1996 Nov 28;384(6607):368-72
references: 8934524
references: J Neurosci. 2003 Feb 1;23(3):876-82
references: 12574416
references: Br J Pharmacol. 2005 Sep;146(2):189-97
references: 15997239
references: Neurocrit Care. 2005;3(2):146-9
references: 16174884
references: Nat Neurosci. 2003 Mar;6(3):309-15
references: 12548289
references: Anesthesiology. 2007 Sep;107(3):427-36
references: 17721245
references: Paediatr Anaesth. 2005 Oct;15(10):879-85
references: 16176317
references: Anesth Analg. 2009 Sep;109(3):801-6
references: 19690249
references: Pediatr Res. 2007 Sep;62(3):283-90
references: 17551412
references: Toxicology. 2011 Nov 28;290(1):96-101
references: 21920406
references: Anesth Analg. 1977 Jul-Aug;56(4):538-42
references: 560141
references: Anesthesiology. 2012 Mar;116(3):586-602
references: 22354242
references: Anesthesiology. 2011 Jan;114(1):49-57
references: 21169791
references: Anesth Analg. 2004 Dec;99(6):1648-1654
references: 15562048
references: Anesthesiology. 2009 Apr;110(4):796-804
references: 19293700
references: Science. 2000 Feb 11;287(5455):1056-60
references: 10669420
references: Anesthesiology. 2010 Aug;113(2):360-8
references: 20613483
references: J Cereb Blood Flow Metab. 2010 May;30(5):1017-30
references: 20068576
references: Neuroscience. 2005;135(3):815-27
references: 16154281
references: Anesthesiology. 2010 May;112(5):1155-63
references: 20418696
references: Biochem Pharmacol. 2012 Aug 15;84(4):558-63
references: 22705347
references: Proc Natl Acad Sci U S A. 2002 Nov 12;99(23):15089-94
references: 12417760
references: Anesthesiology. 1999 Mar;90(3):758-65
references: 10078677
references: Anesthesiology. 2009 Apr;110(4):862-8
references: 19293695
references: Crit Care Med. 1999 Jan;27(1):196-9
references: 9934916
references: Exp Neurol. 2004 Nov;190 Suppl 1:S8-21
references: 15498537
references: Cell Tissue Res. 2001 Aug;305(2):187-202
references: 11545256
references: Science. 1999 Jan 1;283(5398):70-4
references: 9872743
references: Paediatr Anaesth. 2002 Nov;12(9):770-4
references: 12519135
references: Exp Neurol. 1985 Sep;89(3):520-9
references: 4029333
references: Anesthesiology. 2012 Jul;117(1):64-71
references: 22617253