Anesthetic-induced developmental neurotoxicity: causes, prospective studies and possible interventions

Mechanism of AIDN: The agents lead to damage in the hippocampus and amygdala which leads to learning and memory disturbances subsequently. The γ-aminobutyric acid (GABA)-ergic and glutaminergic neurons have been found to undergo apoptosis due to exposure. Experimental studies have shown that nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation occurs due to inhalational anesthetics, which leads to superoxide overproduction, mitochondrial dysfunction and apoptosis. Other proposed mechanisms are altered expression of ligand-gated ion channels and disturbance to intracellular calcium homeostasis. The concentration of agent used, type of agent and duration of exposure are also factors that are considered responsible for AIDN.1 Although single exposure for a small duration might be safe, children requiring multiple anesthetic exposures could theoretically manifest with developmental issues in their adult life.