March 2014

Mark your calendar!

SmartTots Workshop

Friday, June 20, 2014: Sheraton Crystal City Hotel, Washington, DC

Open to all interested professionals. No registration fee.

Workshop Agenda:

  • Updates on the ongoing studies, including results to date
  • Additional studies needed to answer the questions about the potential neurotoxicity of anesthetics in the developing human brain
  • Dealing with the uncertainties about anesthetics and children in the practice environment
  • Does the Consensus Statement on the Use of Anesthetics and Sedatives in Children need revision?
  • Raising the funds required to conduct the needed studies

Please contact Rebekah Davies, IARS Program Manager for more information or to register for the workshop.  [email protected]   415-296-6915

Research News & Updates

Functional implications of an early exposure to general anesthesia: are we changing the behavior of our children?

A review of presently available evidence regarding anesthesia-induced neurocognitive and social behavioral impairments and possible strategies for preventing them, and of limited and somewhat controversial evidence that examines the effects of nociception and surgical stimulation on anesthesia–induced developmental neurotoxicity. Read more

Anesthesia considerations in pediatric glaucoma management

As the potential long-term adverse neurodevelopmental effects of general anesthesia become better understood, pediatric glaucoma specialists should be cognizant of the relative lifelong risks and benefits of repeat examinations under anesthesia in young patients. Read more

Adverse effect of inhalational anesthetics on the developing brain

Experimental studies using animal models have indicated some adverse effect of anesthetics, especially neurotoxicity, in the developing brain.  More evidence is needed before a recommendation can be made to change the way those anesthetics are used in the pediatric population. Two clinical trials underway may provide insight to the potential human neurotoxic effect of anesthetics. Read more

Dual effects of ketamine: neurotoxicity versus neuroprotection in anesthesia for the developing brain

Ketamine is widely used in pediatric anesthesia.  Animal studies have shown that ketamine may have neurotoxic effects on the developing brain.  Other studies have shown ketamine protects the central nervous system by inhibiting inflammation in the developing brain.  Balancing the neurotoxic and neuroprotective effects of ketamine on the developing brain may be possible, but further study is required. Read more

Isoflurane-induced Apoptosis of Neurons and Oligodendrocytes in the Fetal Rhesus Macaque Brain

Isoflurane anesthesia for 5 hours causes death of neurons and oligodendrocytes in the G120 fetal NHP brain. In the fetal brain, as the authors previously found in the neonatal NHP brain, oligodendrocytes become vulnerable when they are just achieving myelination competence. The neurotoxic potential of isoflurane increases between the third trimester (G120) and the neonatal period in the NHP brain. Read more

Anesthesia for the young child undergoing ambulatory procedures: current concerns regarding harm to the developing brain.

Sedation and anesthesia are often necessary for children at any age, and are frequently provided in ambulatory settings. Concerns have mounted, based on both laboratory studies including various mammalian species and retrospective human clinical studies, that the very drugs that induce sedation and anesthesia may trigger an injury in the developing brain, resulting in long-lasting neurobehavioral consequences. Read more

The potential dual effects of sevoflurane on AKT/GSK3beta signaling pathway.

Anesthetic sevoflurane might induce a dual effect (increase versus decrease) on the activation of the AKT/GSK3beta signaling pathway. These studies have established a system to perform further studies to determine the effects of sevoflurane on brain function. Read more

Physiological disturbance may contribute to neurodegeneration induced by isoflurane or sevoflurane in 14 day old rats.

Volatile anesthetics are widely used in pediatric anesthesia but their potential neurotoxicity raise significant concerns regarding sequelae after anesthesia.  These findings could suggest physiological disturbance induced by isoflurane or sevoflurane anesthesia may also contribute to their neurotoxicity. Read more

Early life exposure to sevoflurane impairs adulthood spatial memory in the rat.

Early life exposure to sevoflurane can result in spatial memory impairments in adulthood and the shorter the interval between exposures, the greater the deficit. Read more

Educational outcome in adolescence following pyloric stenosis repair before 3 months of age: a nationwide cohort study.

Young age at anesthetic exposure is believed to be critical, but human studies are scarce. This study found children operated for pyloric stenosis (PS) before 3 months of age have educational performance tests similar to the background population at age 15-16 years after adjusting for known confounders. The higher nonattainment rate could suggest that a subgroup of PS children is developmentally disadvantaged. Read more

Modeling anesthetic developmental neurotoxicity using human stem cells.

Development of an in vitro neurogenesis system using human stem cells has opened up avenues of research for advancing our understanding of human brain development and the issues relevant to anesthetic-induced developmental toxicity in human neuronal lineages. Read more