Article Name: Neurotoxicity of general anesthetics: an update
Short Citation: Curr Pharm Des 2012;18(38):6232-40.
Article Year: 2012
Lead Author(s): Vlisides et al.
PubMed PMID: 22762477
Full Citation: Vlisides P, Xie Z. Neurotoxicity of general anesthetics: an update. Curr Pharm Des 2012;18(38):6232-40.
Organ System: Neurological
Science Area: Pharmacology / Medical Therapy
Article Type: Review Article
Findings: All currently used anaesthetic agents (isoflurane, sevoflurane, desflurane, nitrous oxide, proposal, ketamine) cause neurotoxicity. The cellular nature of this toxicity is unique for each agent and has been extensively demonstrated in cell-culture and animal studies. Such mechanisms include neuroapoptosis, caspase activation and beta-amyloid protein accumulation. Clinical studies contain many confounders and are generally underpowered to detect important differences. Further data is necessary.
Additional comments from Journal Gems contributors: The article suggests desflurane toxicity may be less than older agents however clinical data is lacking. Mechanisms of reducing the impact of neurotoxicity at the extremes of age (including reducing post-operative cognitive dysfunction) remain elusive.