title: Effect of combining anesthetics in neonates on long-term cognitive function.
abstract: BACKGROUND
  With growing evidence that anesthesia exposure in infancy affects cognitive development, it is important to understand how distinct anesthetic agents and combinations can alter long-term memory. Investigations of neuronal death suggest that combining anesthetic agents increases the extent of neuronal injury. However, it is unclear how the use of simultaneously combined anesthetics affects cognitive outcome relative to the use of a single agent.
  
  
  METHODS
  Postnatal day 7 (P7) male rats were administered either sevoflurane as a single agent or the combined delivery of sevoflurane with nitrous oxide at 1 Minimum Alveolar Concentration for 4 h. Behavior was assessed in adulthood using the forced alternating T-maze, social recognition, and context-specific object recognition tasks.
  
  
  RESULTS
  Animals exposed to either anesthetic were unimpaired in the forced alternating T-maze test and had intact social recognition. Subjects treated with the combined anesthetic displayed a deficit, however, in the object recognition task, while those treated with sevoflurane alone were unaffected.
  
  
  CONCLUSIONS
  A combined sevoflurane and nitrous oxide anesthetic led to a distinct behavioral outcome compared with sevoflurane alone, suggesting that the simultaneous use of multiple agents may uniquely influence early neural and cognitive development and potentially impacts associative memory.
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Lee
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: Obhi D
authors.initials: OD
authors.lastname: Hazarika
authors.affiliation: University of California San Francisco School of Pharmacy, United States.
authors.forename: Gabe R
authors.initials: GR
authors.lastname: Quitoriano
authors.affiliation: Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Lin
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: Jason
authors.initials: J
authors.lastname: Leong
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: Heather
authors.initials: H
authors.lastname: Brosnan
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: John T
authors.initials: JT
authors.lastname: Chan
authors.affiliation: Keck School of Medicine of USC, United States.
authors.forename: Laura D V
authors.initials: LD
authors.lastname: May
authors.affiliation: Arizona College of Osteopathic Medicine, United States.
authors.forename: Damon
authors.initials: D
authors.lastname: Yu
authors.affiliation: University of Arizona College of Medicine, United States.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Alkhamisi
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
authors.forename: Greg
authors.initials: G
authors.lastname: Stratmann
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California San Francisco, United States. Electronic address: sallj@anesthesia.ucsf.edu.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Sall
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D000831:Animals, Newborn; D001835:Body Weight / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D006185:Habituation, Psychophysiologic / Q000187:drug effects; D007398:Interpersonal Relations; D008297:Male; D018782:Maze Learning / Q000187:drug effects; D008738:Methyl Ethers / Q000494:pharmacology*; D009609:Nitrous Oxide / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D021641:Recognition, Psychology / Q000187:drug effects; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide
keywords: Memory; Neurotoxicity; Sevoflurane+/−nitrous oxide; Volatile anesthetics