Document Detail


General anesthesia improves fetal cerebral oxygenation without evidence of subsequent neuronal injury.
MedLine Citation:
PMID:  15758947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anesthetic exposure during pregnancy is viewed as a relatively routine medical practice. However, recent rodent studies have suggested that common anesthetic agents can damage the developing brain. Here we assessed this claim in a higher order species by exposing previously instrumented near-term pregnant sheep at gestational day 122 (+/-1) to a combination of midazolam, sodium thiopental, and isoflurane at clinically relevant doses and means of anesthetic delivery (i.e., active ventilation). Four hours of maternal general anesthesia produced an initial increase in fetal systemic oxygenation and a sustained increase in fetal cerebral oxygenation, as determined by in utero near-infrared spectroscopy. Postexposure monitoring failed to identify changes in physiologic status that could be injurious to the fetal brain. Finally, through the histologic assessment of noninstrumented sheep at the same gestational time point, we found no evidence for a direct fetal neuro-toxic effect of our triple-drug regimen. Collectively, these results appear to corroborate the presumed safety of inhalational anesthetic use during pregnancy.
Authors:
Rebecca J McClaine; Kenichiro Uemura; Sebastian G de la Fuente; Roberto J Manson; John V Booth; William D White; Kurt A Campbell; Deborah J McClaine; Paul B Benni; W Steve Eubanks; James D Reynolds
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  25     ISSN:  0271-678X     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-26     Completed Date:  2005-08-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1060-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Division of Women's Anesthesia, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General* / adverse effects
Anesthesia, Obstetrical*
Anesthetics, Inhalation* / adverse effects
Anesthetics, Intravenous* / adverse effects
Animals
Blood Gas Analysis
Brain / embryology,  pathology
Brain Chemistry / drug effects*
Female
Fetus / physiology
Hemodynamics / drug effects
Hemoglobins / metabolism
In Situ Nick-End Labeling
Isoflurane* / adverse effects
Midazolam* / adverse effects
Neurons / drug effects,  pathology*
Oxygen Consumption / drug effects*
Pregnancy
Sheep
Thiopental* / adverse effects
Grant Support
ID/Acronym/Agency:
NS 42664/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Hemoglobins; 26675-46-7/Isoflurane; 59467-70-8/Midazolam; 76-75-5/Thiopental

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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