Nagappa Saraswathi, Kalappa Sandhya, Sridhara Raghavendra B, Biligi Dayananda S, Annapoorneshwari R
Department of Anesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Department of Pathology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2025 Apr-Jun;41(2):323-332. doi: 10.4103/joacp.joacp_26_24. Epub 2024 Aug 16.
Preclinical studies in rodents and primates have shown that anesthesia was neurotoxic to the developing brain after exposure in the neonatal period. Sevoflurane a commonly used inhalational anesthetic, especially in pediatric surgery, might cause behavioral impairment in the developing brain. Although favored for its rapid onset and minimal airway disturbance, sevoflurane has been implicated in neurotoxic effects such as anesthesia-induced developmental neurotoxicity in rodents, through various mechanisms. One of the mechanisms was disturbances in methylation metabolism which can be easily treated if it is proved. This study aims to evaluate the levels of S-adenosylmethionine [SAM] following sevoflurane anesthesia in neonates and to correlate the duration of sevoflurane exposure and S-adenosylmethionine levels.
Sixty neonates were included in the study under general anesthesia. Pre- and postsevoflurane exposure arterial blood samples were collected in ethylenediamine tetraacetic acid vacutainers. Each sample was centrifuged at 1000 rpm for 10 min. Plasma was separated and stored at -80°C, then subjected to S-adenosylmethionine enzyme-linked immunoassay test for preand postsevoflurane exposure levels of SAM.
The difference between the pre- and post-SAM values is not statistically significant and also with increasing the duration of sevoflurane exposure there was no reduction in the SAM levels ( = 0.17), and the correlation was not significant ( = 0.18).
Single exposure to sevoflurane does not impact SAM levels in neonates undergoing general anesthesia.
啮齿动物和灵长类动物的临床前研究表明，新生儿期接触麻醉药对发育中的大脑具有神经毒性。七氟醚是一种常用的吸入性麻醉剂，尤其在小儿外科手术中使用，可能会对发育中的大脑造成行为损害。尽管七氟醚因其起效迅速和气道干扰最小而受到青睐，但它已通过各种机制与诸如啮齿动物麻醉诱导的发育性神经毒性等神经毒性作用相关联。其中一种机制是甲基化代谢紊乱，如果得到证实则易于治疗。本研究旨在评估新生儿七氟醚麻醉后S-腺苷甲硫氨酸（SAM）的水平，并将七氟醚暴露时间与S-腺苷甲硫氨酸水平相关联。
60例接受全身麻醉的新生儿纳入本研究。在七氟醚暴露前后，采集乙二胺四乙酸真空采血管中的动脉血样本。每个样本以1000转/分钟的速度离心10分钟。分离血浆并储存在-80°C，然后进行S-腺苷甲硫氨酸酶联免疫分析测试，以检测七氟醚暴露前后的SAM水平。
SAM值前后差异无统计学意义，且随着七氟醚暴露时间的增加，SAM水平也没有降低（P = 0.17），相关性不显著（P = 0.18）。
单次接触七氟醚对接受全身麻醉的新生儿的SAM水平没有影响。
