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Influence of general anesthetic exposure in developing brain on cognition and the underlying mechanisms

ZHAO Xin^1,2, HAO Li-Jun^1,2,3, ZHANG Yu-Tong^1,2, ZHANG Yu^1,2, ZHANG Ce^1,2,*

¹Department of Physiology, Shanxi Medical University, Taiyuan 030001, China；²Key Laboratory for Cellular Physiology of Ministry of Education, Shanxi Medical University, Taiyuan 030001, China；³ Department of Anesthesiology, Shanxi Provincial People’s Hospital, Taiyuan 030012, China

Abstract

With the evolution of medical techniques and technology, an increasing number of infants, neonates, and fetuses are

exposed to general anesthesia for clinical diagnostic and therapeutic process. The neurotoxic effects of general anesthetics on developing brain have been a subject of concern and considerable research interest. Population-based study confirmed that single short-term general anesthetic exposure does not affect nervous system function, but multiple exposures to general anesthesia could damage cognitive function. Animal studies further discovered the underlying mechanisms. Nervous system is most susceptible to general anesthetics during the brain growth spurt. The time-point is more critical than the duration of exposure to general anesthetics. General anesthetics can induce intracellular calcium overload, disturb energy metabolism, promote cell apoptosis and lead to cell loss. General anesthetics can damage synaptic structure, transmission and plasticity, and impair brain function. High throughput omics technologies have been used to screen the differentially expressed genes induced by general anesthetics, which provide further understanding of the mechanism of general anesthetics affecting cognitive function. This review provides an update on the pathophysiologic mechanisms underlying the anesthesia-neurotoxicity, which will be helpful to provide instructions for the clinical use of general anesthesia in children.

Key words: general anesthetic; developing brain; cognitive; influence; mechanism

Received: 2019-01-15　　Accepted: 2019-04-28

Corresponding author: 张策　　E-mail: cezh2002@yahoo.com

DOI: 10.13294/j.aps.2019.0048

Citing This Article：

ZHAO Xin, HAO Li-Jun, ZHANG Yu-Tong, ZHANG Ce. Influence of general anesthetic exposure in developing brain on cognition and the underlying mechanisms. Acta Physiol Sin 2019; 71 (5): 749-759 (in Chinese with English abstract).