The risks and side effects of an epidural include infection at the site of the needle and headache.
Anesthetic Agent
Anesthetic is a drug or substance that blocks pain and causes loss of feeling. Anesthetic drugs are used on patients prior to surgery to numb part of the body or to make a the patient unconscious during the surgical procedure. Learn more about anesthetics from our experts.
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1 AnswerA
"Anesthetic neurotoxicity is not just a topic of interest to anesthesiologists and researchers; it is now considered a public health concern, having attracted the attention of the U.S. Food and Drug Administration and the population at large. The molecular mechanisms linking anesthetic exposure and neuron cell death must be identified for this phenomenon to be prevented.
Multiple animal studies have demonstrated that anesthetic exposure during a critical period of synaptogenesis causes cell death in the brains of young rodents and nonhuman primates; these animals demonstrate deficits in learning and memory later in life. How these findings translate to humans is still unclear. Retrospective analyses of select pediatric populations have suggested that children with multiple anesthetic exposures have an increased likelihood of developing learning disabilities and behavioral problems. However, the retrospective nature of these studies, which contain many confounding factors, makes it impossible to assign causality." (Katherine R. Gentry, MD, et al., "Early Developmental Exposure to Volatile Anesthetics Causes Behavioral Defects in Caenorhabditis elegans," Anesthesia & Analgesia, January 2013, pp. 185-189.) -
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"The greatest vulnerability of the developing brain to anesthetics occurs at the time of rapid synaptogenesis or so-called brain growth spurt period. In rodents, this critical period lasts from approximately postnatal day 0 to 10. For rhesus monkeys, this period takes place after approximately 115 days of gestation and up to postnatal day 60. In humans, it starts from the third trimester and continues two to three years after birth. However, it is unclear whether anesthetic-induced neuronal death is the direct cause of long-term neurocognitive dysfunction. Many developmental events (e.g., neurogenesis, synaptogenesis and neuron structure remodeling) occur within this period.
Multiple sequential steps are involved in neurogenesis including neural stem cell (NSC) proliferation and the differentiation of NSCs into neurons. Thus, neuronal cell death may not be the only consequence caused by general anesthetics. Anesthetics may perturbate neural development by influencing NSC proliferation, neurogenesis, synaptogenesis and neuronal survival." (Xiaowen Bai, MD, PhD, et al., "Ketamine Enhances Human Neural Stem Cell Proliferation and Induces Neuronal Apoptosis via Reactive Oxygen Species-Mediated Mitochondrial Pathway," Anesthesia & Analgesia, April 2013, pp. 869-880.) -
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"In one of the earliest studies of anesthetic neurodegeneration in rodents, researchers demonstrated that exposure to midazolam, nitrous oxide, and isoflurane (ISO), in postnatal day seven rats, resulted in widespread histological evidence of apoptosis as well as deficits in spatial reference memory when subjected to behavioral testing. In the Morris water maze, exposed young adults had slower rates of memory acquisition than control animals; when retested as adults, exposed animals also demonstrated impaired retention performance. Similar results have been obtained in nonhuman primates. Neonatal rhesus monkeys exposed to 24 hours of ketamine demonstrated persistent cognitive defects when tested out to three years of age." (Katherine R. Gentry, MD, et al., "Early Developmental Exposure to Volatile Anesthetics Causes Behavioral Defects in Caenorhabditis elegans," Anesthesia & Analgesia, January 2013, pp. 185-189.)