Eshanika Manchanda - Department of Neonatology
The art of general anesthesia was first introduced in 1846 at Massachusetts General Hospital for a dental extraction using diethyl ether. Since then, anesthesia has greatly advanced and become an indispensable part of modern medicine, relieving millions of patients in the United States each year. However, throughout the years there has remained a crucial question of whether neonatal anesthesia is safe for the fragile central nervous system of the developing infant. While the toxic and neurological effects are still relatively unclear, emerging studies have shown that developing neonatal brains are sensitive to disruptions, long-lasting cognitive and behavioral deficiencies, as well as learning and memory deficits under the influence of anesthetics. Its propensity to affect the gamma-aminobutyric acid (GABA) system seems to alter the excitatory-inhibitory balance that manifests following anesthesia exposure. The key markers to measure the physiological consequences are neurotoxicity and neuroapoptosis affecting cell types such as oligodendrocytes, astrocytes, and interneurons. The developing brain has a dynamic mechanism of establishing and maintaining neuronal connections, and infantile anesthesia may have long-term neurodevelopmental consequences.
It is not surprising that anesthesia has become a vital component of medicine, as the minimization of pain and movement during procedures has become a top priority in patient care. In many developing nations, general anesthesia is a standard approach to surgeries, however, it remains ambivalent and situational involving neonates due to the uncertainty around the potential implications. Although the development of anesthesia has dramatically transformed medicine to bring about relief and relaxation, it is vital that researchers continue to dive into neonatal anesthesia research or alternatives to elucidate the concerns associated with its use.
References:
Gascoigne, D. A., Serdyukova, N. A., & Aksenov, D. P. (2021). Early Development of the GABAergic System and the Associated Risks of Neonatal Anesthesia. International journal of molecular sciences, 22(23), 12951. https://doi.org/10.3390/ijms222312951
Edited By: Firas Batrash, Editor-in-Chief
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