• Christine N Zanghi and Vesna Jevtovic-Todorovic.
• University of Colorado, Anschutz Medical Campus, Department of Anesthesiology, 12801 E. 17th Ave., Mail Stop 8130, Aurora, CO 80045, United States. Electronic address: CHRISTINE.ZANGHI@UCDENVER.EDU.
• Neurotoxicol Teratol. 2017 Mar 1; 60: 24-32.

AbstractThe year 2016 marked the 15th anniversary since anesthesia-induced developmental neurotoxicity and its resulting cognitive dysfunction were first described. Since that time, multiple scientific studies have supported these original findings and investigated possible mechanisms behind anesthesia-induced neurotoxicity. This paper reviews the existing mechanistic literature on anesthesia-induced neurotoxicity in the context of a holistic approach that emphasizes the importance of both neuronal and non-neuronal cells during early postnatal development. Sections are divided into key stages in early neural development; apoptosis, neurogenesis, migration, differentiation, synaptogenesis, gliogenesis, myelination and blood brain barrier/cerebrovasculature. In addition, the authors combine the established literature in the field of anesthesia-induced neurotoxicity with literature from other related scientific fields to speculate on the potential role of non-neuronal cells and to generate new future hypotheses for understanding anesthetic toxicity and its application to the practice of pediatric anesthesia.Copyright © 2017 Elsevier Inc. All rights reserved.

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