Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, No. 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, People's Republic of China.
Department of Hepatobiliary Surgery, The Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, Guangdong, People's Republic of China.
Neurotox Res. 2018 May;33(4):790-800. doi: 10.1007/s12640-017-9827-5. Epub 2017 Oct 25.
Anesthesia-induced neurotoxicity in immature animals has raised concerns about similar effects occurring in young children. Our study investigated two commonly used anesthetics-sevoflurane and propofol-for neurotoxicity in young children. Forty-seven children (aged 12-36 months) undergoing hypospadias repair surgery were randomized to receive sevoflurane (SG, n = 24) or propofol (PG, n = 23) general anesthesia. Venous blood was collected at three different times-immediately after induction, 2 h, and 3 days after surgery. The cellular portion was assessed for antioxidant defense and DNA damage, using enzyme assay kits and qRT-PCR, respectively, while serum was used to treat cultured neural stem cells (NSCs). MTT assay and TUNEL staining were performed, and the mRNA levels of antioxidant enzymes and apoptosis indicators were evaluated by qRT-PCR. Antioxidant defense and apoptosis status in the SG group were significantly higher than in the PG group at 2 h after surgery. Additionally, exposure of NSCs to postoperative serum of the SG group resulted in decreased cell density and viability, increased TUNEL-positive cells, elevated mRNA levels of antioxidant enzymes, and cleaved caspase-3 expression. Our data shows for the first time that in young children, administration of sevoflurane, but not propofol, leads to temporally increased antioxidant defense and apoptosis status as well as damage of NSCs.
麻醉诱导的神经毒性在未成熟动物中引起了对类似效应在幼儿中发生的担忧。我们的研究调查了两种常用的麻醉剂——七氟醚和丙泊酚——在幼儿中的神经毒性。47 名（年龄 12-36 个月）接受尿道下裂修复手术的儿童被随机分为接受七氟醚（SG 组，n=24）或丙泊酚（PG 组，n=23）全身麻醉。在三个不同时间点采集静脉血——诱导后立即、2 小时和手术后 3 天。使用酶测定试剂盒和 qRT-PCR 分别评估细胞部分的抗氧化防御和 DNA 损伤，同时使用血清处理体外培养的神经干细胞（NSCs）。进行 MTT 测定和 TUNEL 染色，并通过 qRT-PCR 评估抗氧化酶和凋亡指标的 mRNA 水平。SG 组在手术后 2 小时的抗氧化防御和凋亡状态明显高于 PG 组。此外，将 NSCs 暴露于 SG 组术后血清中导致细胞密度和活力降低、TUNEL 阳性细胞增加、抗氧化酶的 mRNA 水平升高和裂解的 caspase-3 表达。我们的数据首次表明，在幼儿中，给予七氟醚而不是丙泊酚会导致抗氧化防御和凋亡状态暂时增加以及 NSCs 损伤。
