• Dean B Andropoulos.
• Texas Children's Hospital Department of Anesthesiology, Perioperative and Pain Medicine, 6551 Main St., E 1940, Houston Texas 77030, USA. Electronic address: dra@bcm.edu.
• Best Pract Res Clin Anaesthesiol. 2023 Mar 1; 37 (1): 526252-62.

AbstractOver the past 20 years, hundreds of preclinical studies of the developing central nervous system have been published concluding that the common γ-aminobutryic acid and N-methyl-d-aspartate binding anesthetic agents cause neuroapoptosis and other forms of neurodegeneration. Some clinical studies, including controlled trials, both prospective and ambidirectional in design, indicate an association between any exposure (single or multiple) to anesthesia and surgery at a young age, generally less than 3-4 years, and later behavioral and neurodevelopmental problems. A consideration of neuroprotective strategies is important, as scientists and clinicians alike ponder methods to potentially improve the neurodevelopmental outcomes of the millions of infants and children who undergo surgery and anesthesia annually around the world. This review will address plausible neuroprotective strategies and include alternative anesthetics, neuroprotective nonanesthetic drugs, and physiologic neuroprotection.Copyright © 2022 Elsevier Ltd. All rights reserved.

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