Genel Anestezi Santral Sinir Sistemine zararlı mıdır?

Günümüzde genel anestezinin santral sinir sistemine etkisi sağlıklı genç yetişkinlerde önemli bir sorun olarak karşımıza çıkmazken, yapılan bir çok hayvan deneyi yanında az ama önemli klinik çalışmalar, yaşamın erken veya geç dönemlerinde santral sinir sistemi üzerine anestezik toksisite kuşkusunu güçlendirmektedir.

Is General Anesthesia Harmful for the Central Nervous System?

Nowadays, while the effects of general anesthesia on central nervous system is not considered to be an important problem on healthy young adults, alongside many experiments on animals, few but significant clinical studies strengthenthe suspicion of anesthetic toxicity on the central nervous system in early or late ages

___

  • 1-Jackson K. Psychiological preparation as a method of reducing emotional trauma of anesthesia in children. Anesthesiol 1951; 12:293–300.
  • 2-Wells BA, Keats AS, Cooley DA. Increased tolerance to cerebral ischemia produced by general anesthesia during temporary carotid occlusion. Surgery 1963; 54;216–23.
  • 3- Hoffman WE, Charbel FT, Edelman G, Ausman JI. Thiopental and desflurane treatment for brain protection. Neurosurgery 1998; 43:1050–3.
  • 4-Pape M, Engelhard K, Eberspächer E et al The long-term effect of sevoflurane on neuronal cell damage and expression of apoptotic factors after cerebral ischemia and reperfusion in rats. Anesth Analg. 2006; 103:173–79.
  • 5- Khatibi NH, Ma Q, Rolland W, Ostrowski R et al. Isoflurane posttreatment reduced brain injury after an intracerebral hemorrhagic stroke in mice. Anesth Analg 2011; 113:343–8.
  • 6- Chen H Burris M, Fajilan A, Spagnoli F, Tang J, Zhang JH. Prolonged exposure to isoflurane ameliorates infarction severity in the rat pup model of neonatal hypoxia-ischemia. Transl. Stroke Res 2011; 2;382–90.
  • 7- Li H, Yin J, Li L, Deng J, Zuo Z. Isoflurane postconditioning reduces ischemia-induced nuclear factor-κB activation and interleukin 1β production to provide neuroprotection in rats and mice. Neurobiol. Dis 2013; 54:216–24.
  • 8- Yan J, Jiang H. Dual effects of ketamine: Neurotoxicity versus neuroprotection in anesthesia for the developing brain. J. Neurosurg. Anesthesiol 2014; 26:155–60.
  • 9- Zheng S, Zuo Z. Isoflurane preconditioning induces neuroprotection against ischemia via activation of p38 mitogen-activated protein kinase. Mol Pharmacol 2004; 65:1172-80.
  • 10- Zheng S, Zuo Z. Isoflurane preconditioning reduces Purkinje cell death in an in vitro model of rat cerebellar ischemia. Neuroscience 2003; 118(1):99- 106.
  • 11- Kapinya KJ, Löwl D, Fütterer C et al. Tolerance Against Ischemic Neuronal Injury Can Be Induced by Volatile Anesthetics and Is Inducible NO Synthase Dependent. Stroke 2002; 33:1889-98.
  • 12- McMurtrey RJ, Zuo Z. Isoflurane preconditioning and postconditioning in rat hippocampal neurons. Brain Res 2010; 1358:184-90.
  • 13- Lee JJ, Li L, Jung H-H Zuo Z. Postconditioning with isoflurane reduced ischemiainduced brain injury in rats. Anesthesiol 2008; 108:1055-62.
  • 14- Komuro H, Rakic P. Modulation of neuronal migration by NMDA receptors. Science. 1993; 260:95– 7.
  • 15- Jevtovic-Todorovic V. General Anesthetics and Neurotoxicity: How Much Do We Know? Anesthesiol Clin 2016; 34(3):439-51
  • 16-Frank NP, Lieb RW. Seeing the Light: Protein Theories of General Anesthesia. Anesthesiology 2004; 101: 235-7
  • 17-Hemmings HC Jr, Akabas MH, Goldstein PA, Trudell JR, Orser BA, Harrison NL. Emerging molecular mechanisms of general anesthetic action. Trends Pharmacol Sci 2005; 26(10):503-10.
  • 18-Rudolph U, Antkowiak B. Molecular and neuronal substrates for general anaesthetics. Nat Rev Neurosci 2004; 5(9):709-20.
  • 19- Jevtovic-Todorovic V, Hartman RE, Izumi Y et al. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci 2003; 23:876–82.
  • 20-Ben-Ari Y. Excitatory actions of GABA during development: the nature of the nurture. Nat Rev Neurosci. 2002; 3:728–39.
  • 21- Zhang Y, Dong Y, Wu X et al. The mitochondrial pathway of anesthetic isofluraneinduced apoptosis. J Biol Chem 2010 5; 285(6):4025-37.
  • 22- HMT Batista, GBM Silveira, Sampaio LA et al. Are General anesthetics neurotoxic? International Archives of Medicine 2015; Vol. 8 No. 53 :1-8
  • 23-Bilotta F, Novelli M, Yörükoğlu D. Anestetik Nörotoksisite. Ed. Keçik Y Temel Anestezi. Ankara: Güneş Tıp Kitabevi; 2016:1121–4
  • 24-Hansen TG, Lönnqvist PA.The rise and fall of anaesthesia-related neurotoxicity and the immature developing human brain. Acta Anaesthesiol Scand 2016; 60(3):280-3.
  • 25- Brown JK, Omar T, O’Regan M. Brain development and the development of tone and muscle. In: KJC, HF, editor. Neurophysiology and the Neuropsychology of Motor Development. Mackeith Press; 1997. p. 1-41.
  • 26- Dobbing J, Sands J. The brain growth spurt in various mammalian species. Early Hum Dev. 1979; 3:79–84.
  • 27- Rizzi S, Carter LB, Ori C, JevtovicTodorovic V. Clinical anesthesia causes permanent damage to the fetal guinea pig brain. Brain Pathol 2008; 18:198–210.
  • 28- Yon JH, Daniel-Johnson J, Carter LB, Jevtovic-Todorovic V. Anesthesia induces neuronal cell death in the developing rat brain via the intrinsic and extrinsic apoptotic pathways. Neuroscience 2005; 35:815–27.
  • 29- Paule MG, Li M, Allen RR, et al. Ketamine anesthesia during the first week of life can cause long-lasting cognitive deficits in rhesus monkeys. Neurotoxicol Teratol 2011; 33:220–30.
  • 30- Raper J, Alvarado MC, Murphy KL, Baxter MG. Multiple Anesthetic Exposure in Infant Monkeys Alters Emotional Reactivity to an Acute Stressor. Anesthesiol 2015; 123(5):1084–92.
  • 31- Backman ME, Kopf AW. Iatrogenic effects of general anesthesia in children: considerations in treating large congenital nevocytic nevi. J Dermatol Surg Oncol 1986; 12:363–7
  • 32- Shen X, Dong Y, Xu Z, et al. Selective anesthesia-induced neuroinflammation in developing mouse brain and cognitive impairment. Anesthesiol 2013; 118:502–15.
  • 33- Stratmann G, Sall JW, May LD et al Isoflurane differentially affects neurogenesis and long-term neurocognitive function in 60-day-old and 7-day-old rats. Anesthesiol 2009; 110:834–48.
  • 34- Jevtovic-Todorovic V, Hartman RE, Izumi Y et al. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci 2003; 23:876–82.
  • 35- Sun LS, Li G, Dimaggio C, et al. Anesthesia and neurodevelopment in children: time for an answer? Anesthesiol 2008; 109:757–61.
  • 36- Ing CH, DiMaggio CJ, Malacova E et al. Comparative analysis of outcome measures used in examining neurodevelopmental effects of early childhood anesthesia exposure. Anesthesiol 2014; 120:1319–32.
  • 37- Wilder RT, Flick RP, Sprung J at all. Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiol 2009; 110(4):796-804.
  • 38- Ing CH, DiMaggio CJ, Whitehouse AJ, et al. Neurodevelopmental Outcomes After Initial Childhood Anesthetic Exposure Between Ages 3 and 10 Years. J Neurosurg Anesthesiol 2014 ; 26(4):377-86.
  • 39- Davidson AJ. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awakeregional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet 2016 16; 387(10015): 239–50.
  • 40- Bosnjak ZJ, Logan S, Liu Y, Bai X. Recent Insights Into Molecular Mechanisms of PropofolInduced Developmental Neurotoxicity: Implications for the Protective Strategies. Anesth Analg 2016 Nov;123(5):1286-96.
  • 41- Krzisch M, Sultan S, Sandell J et al. Propofol anesthesia impairs the maturation and survival of adult-born hippocampal neurons. Anesthesiol 2013; 118:602–10.
  • 42- Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME: Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA 1995; 274(1):44-50.
  • 43- Nielson WR, Gelb AW, Casey JE, Penny FJ, Merchant RN, Manninen PH. Long-term cognitive and social sequelae of general versus regional anesthesia during arthroplasty in the elderly. Anesthesiol 1990; 73(6):1103-9
  • 44- Krenk L, Rasmussen LS, Kehlet H. New insights into the pathophysiology of postoperative cognitive dysfunction. Acta Anaesthesiol Scand 2010;54:951–6.
  • 45- Monk TG, Weldon BC, Garvan CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiol 2008; 108:18–30.
  • 46- Moller JT, Cluitmans P, Rasmussen LS et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet 1998; 351(9106):857-61.
  • 47- Raz, N. Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings. In F. I. M. Craik & T. A. Salthouse (Eds.), The handbook of aging and cognition 2000:pp. 1–90. Mahwah, NJ: Erlbaum.
  • 48- Raz, N. The aging brain observed in vivo: Differential changes and their modifiers. In R. Cabeza, L. Nyberg, & D. C. Park (Eds.), Cognitive neuroscience of aging: Linking cognitive and cerebral aging 2004:pp. 17–55. New York: Oxford University Press.
  • 49- Andres, P., Guerrini, C., Phillips, L. H., & Perfect, T. J. Differential effects of aging on executive and automatic inhibition. Dev Neuropsychol 2008; 33:101–23.
  • 50- Porges EC, Woods AJ, Edden RA at all. Frontal Gamma-Aminobutyric Acid Concentrations Are Associated With Cognitive Performance in Older Adults. Biol Psychiatry Cogn Neurosci Neuroimaging 2017; 2(1):38-44.
  • 51- Liu F, Rainosek SW, Sadovova N et al. Protective effect of acetyl-L-carnitine on propofolinduced toxicity in embryonic neural stem cells. Neurotoxicology. 2014; 42:49–57.
  • 52- Straiko MM, Young C, Cattano D et al. Lithium protects against anesthesia-induced developmental neuroapoptosis. Anesthesiol 2009; 110:862–8.
  • 53- Zacharias R, Schmidt M, Kny J et al. Dosedependent effects of erythropoietin in propofol anesthetized neonatal rats. Brain Res. 2010; 1343:14–9.
  • 54-Young J, Murthy L, Westby M, Akunne A, O'Mahony R; Guideline Development Group. Diagnosis, prevention, and management of delirium: summary of NICE guidance. BMJ 2010; 28 vol:341:247-9.
  • 55- Perez-Zoghbi JF, Zhu W, Grafe MR, Brambrink AM. Dexmedetomidine-mediated neuroprotection against sevoflurane-induced neurotoxicity extends to several brain regions in neonatal rats. Br J Anaesth 2017; 1;119(3):506-16.
  • 56- Perez-Zoghbi JF, Zhu W, Grafe MR and Brambrink AM. Dexmedetomidine-mediated neuroprotection against sevoflurane-induced neurotoxicity extends to several brain regions in neonatal rats. Br J Anaesth 2017; 119 (3): 506–16.
  • 57- Xu KX, Tao J, Zhang N, Wang JZ. Neuroprotective properties of vitamin C on equipotent anesthetic concentrations of desflurane, isoflurane, or sevoflurane in high fat diet fed neonatal mice. Int J Clin Exp Med 2015; 8(7):10444-58
  • 58-Satomoto M, Sun Z, Adachi YU, Makita K. Sugammadex-Enhanced Neuronal Apoptosis following Neonatal Sevoflurane Exposure in Mice. Anesthesiol Res Pract 2016; 2016:9682703. Epub 2016 Nov 8.
  • 59- Karnwal A ve Lippmann M Letters to the Editor. Anest and Analg.April 2017 • Volume 124. Number 4.
Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
Sayıdaki Diğer Makaleler

Preoperatif Görüntüleme Kılavuzluğunda Laparotomisiz ve Klasik Saptırıcı Kolostomi: Çok Merkezli Vaka Kontrol Çalışması

Mehmet ŞEKER, Nuri OKKABAZ, Yunus Emre ALTUNTAŞ, Mustafa Celalettin HAKSAL, Cengiz EROL, Mustafa ÖNCEL, Nuri Emrah GÖRET

Ektopik Gebelikte Kullanılan Tek Doz Metotreksat Tedavisinin Başarısını Etkileyen Faktörler

Abdülkadir TURGUT, Meryem HOCAOĞLU, Oğuz Devrim YARDIMCI, Taner GÜNAY, Ergül DEMİRÇİVİ BOR, Ateş KARATEKE

Prohepcidin levels in Familial Mediterranean Fever: Possible effect of iron metabolism?

ŞÜKRÜ ÖZAYDIN, Alparslan TANOĞLU, MUSTAFA KAPLAN, Tolga DÜZENLİ, Levent DEMİRTÜRK, Kemal ÖNCÜ, Osman Metin İPÇİOĞLU, Melih ÖZEL, Ahmet Kemal GÜRBÜZ, YUSUF YAZGAN

Akut Pankreatitli Olgularda Ortalama Trombosit Hacmi ve Eritrosit Dağılım Genişliği Düzeyleri ve Hastalık Şiddetiyle Olan İlişkilerinin Belirlenmesi

HALİME HANIM PENÇE, ALPASLAN TANOĞLU, Tolga DÜZENLİ, YUSUF YAZGAN

Comparison of The Outcomes of rFSH Alone Versus rFSH + rLH Protocols in Patients Undergoing Controlled Ovarian Hyperstimulation for IVF Cycles

Yağmur MİNARECİ, Utku ÖZCAN

Ayaktan pulmoner arteryel hipertansiyon hastalarında ortalama trombosit hacmi düzeyinin klinik sonlanımlar üzerine etkisi

Kurtuluş KARAÜZÜM, İrem KARAÜZÜM

Düşük Doğum Ağırlıklı Yenidoğanlarda Santral Olarak Yerleştirilen Santral Venöz Kateterlerin Retrospektif Analizi: 50 Olgu ile Deneyimlerimiz

Nevin Aydın, Abdürrahim DERBENT, Ziya SALİHOĞLU, Osman ESEN, Özal ADIYEKE, Gülseren YILMAZ, Naime YALÇIN

Toplumumuzda Femur Tibia Oranı ile Diz ve Kalça Artrozu İlişkisi

Sefa Giray BATIBAY, Ömer POLAT, Alper GÜLTEKİN

Gelişimsel Kalça Displazisi Tanılı Hastalarda Yürüme Çağında Artroskopik Reduksiyon Ve Dega Asetabuloplasti Tedavisi

Serda DUMAN

Yeni tanı konulan ankilozan spondilitli hastalarda epikardiyal yağ dokusu kalınlığı hastalık ciddiyeti ile ilişkilisi

Halim YILMAZ, Mehmet Sertaç APAYDIN, Halil Ekrem AKKURT, ZAFER BÜYÜKTERZİ