Research Progress of Developmental Neurotoxicity Induced by General Anesthetics / 中山大学学报(医学科学版)

@#With the rapid development of surgery and the expansion of indications for surgical treatment ，the number of non-obstetric operations during pregnancy and infant operations has been increasing. Most of these operations need to be performed under general anesthesia，and the developing brain of fetus and infants are inevitably exposed to general anesthetics. Therefore，in recent years，the neurotoxicity effects of general anesthetics on the developing brain have become the focus and controversy in the medical sciences. Especially in 2016，US Food and Drug Administration（FDA）added black box for warning of general anesthetics commonly used in clinic，which caused confusion among doctors，patients and staffs in the related fields. Therefore，we will elaborate the preclinical and clinical studies of neurotoxicity of general anesthetics in combination with the characteristics of developing brain.

Damage caused by exposure to propofol during gestation of mice / Danos causados pela exposição ao propofol durante a gestação em camundongos

Literature shows that surgical procedure could be necessary at any stage of pregnancy and can cause adverse effects on the mother and fetus. One of the most used anesthetics in surgical centers is propofol however; the safety during pregnancy has not been completely established. The objective of this study was to investigate the possible toxic and teratogenic effects on the intrauterine and post-natal development of mice exposed to the dose of 15 mg kg- 1 propofol on the caudal vein fifth, tenth and fifteenth day of gestation. A significant reduction in weight gain was observed in female mice who received a 15 mg kg-1 dose of propofol on the fifth gestational day. A higher rate of embryonic loss post implantation and resorption was also observed in this group. In regards to physical development, the anesthetic increased significantly the offspring weight gain, the time in which pinna detachment occurred, and the anogenital distance of pups whose females received propofol on the fifteenth day of gestation. Based on these results, we concluded that administration of propofol in the beginning stages of gestation increases the number of abortions and promotes alterations in the physical development of pups whose mothers were anesthetized in the final stages of gestation.

A literatura mostra que o procedimento cirúrgico pode ser necessário em qualquer fase da gravidez podendo causar efeitos adversos sobre a mãe e o feto. Um dos anestésicos mais utilizados nos centros cirúrgicos é o propofol, no entanto, a sua segurança durante a gravidez não foi completamente estabelecida. O objetivo deste estudo foi investigar os possíveis efeitos tóxicos e teratogênicos no desenvolvimento intrauterino e pós-natal de camundongos expostos à dose de 15 mg kg-1 de propofol no quinto, décimo e décimo quinto dia de gestação. Observou-se uma redução significativa no ganho de peso em camundongos fêmeas que receberam uma dose de 15 mg kg-1 de propofol no quinto dia de gestação. Uma taxa maior de perda embrionária pós-implantação e reabsorção também foi observada neste grupo. Em relação ao desenvolvimento físico, o anestésico alterou significativamente o ganho de peso da prole, o tempo em que ocorreu o desprendimento da orelha e a distância anogenital dos filhotes cujas fêmeas receberam propofol no décimo quinto dia de gestação. Com base nesses resultados, concluiu-se que a administração de propofol nos estágios iniciais da gestação aumenta o número de abortos e promove alterações no desenvolvimento físico de filhotes cujas mães foram anestesiadas nos estádios finais da gestação.