The Effects of General Anesthetics on the Developing Brain of Fetus

General Anesthesia is a practice of medically inducing temporary loss of consciousness accompanied by complete or partial loss of pain reflexes. Anesthesia for obstetrics and pediatric surgery is unpreventable for pregnant women and newborn infants with life-threatening disorders requiring a prolonged stay in the intensive care unit (ICU). Despite this, fetal brain development begins in the third week of gestation of intrauterine life. Volatile anesthetics such as sevoflurane, desflurane, isoflurane nitroprusside, etc are used during pregnancy to prevent preterm contractions and inhibit uterine contractility. These volatile anesthetic agents are highly lipid soluble and are of low molecular weight which readily favors for transplacental passage of the volatile anesthetics by simple diffusion and shows numerous effects on the neuronal transmission system. The basic principles of embryo-fetotoxicity were evaluated in the aspects of embryo-fetal effects of drugs such as anesthetics analyzed, and the most commonly used anesthetics were presented with teratogenic risks. Various studies suggested that prolonged exposure to general anesthetics might result in extensive neuroapoptosis (neuronal death), anesthetic neurotoxicity, neuroinflammation, synaptic loss, activation of caspase, and other neurodegenerative changes in the developing human brain. This review briefly summarizes the growth and development of the brain in fetuses and neonates, the data regarding neurotoxicity, and a few key components accountable for neuroapoptosis and causes long-lasting cognitive impairment in fetuses induced due to general anesthetics that is the progress in neurodevelopment in the offspring on anesthetic exposure will be reviewed.