The Role of Intravenous Anesthetics for Neuro: Protection or Toxicity?

• Published in: Neuroscience bulletin Vol. 41; no. 1; pp. 107 - 130
• Main Authors: Wang, Kaixin, Wang, Yafeng, Zhang, Tianhao, Chang, Bingcheng, Fu, Daan, Chen, Xiangdong
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.01.2025
• Subjects: Anesthetics, Intravenous - adverse effects; Anesthetics, Intravenous - pharmacology; Animals; Central Nervous System - drug effects; Dexmedetomidine; Humans; Neuroprotective Agents - pharmacology; Neurotoxicity Syndromes - prevention & control; Propofol; Review; Neuronal injury; Neuroprotection; CNS; Neurotoxicity; PNS; Intravenous anesthetics
• ISSN: 1673-7067; 1995-8218; 1995-8218
• DOI: 10.1007/s12264-024-01265-4

The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine (Dex), propofol, ketamine, etomidate, midazolam, and remimazolam. Apart from their established sedative, analgesic, and anxiolytic properties, an increasing body of research has uncovered neuroprotective effects of intravenous anesthetics in various animal and cellular models, as well as in clinical studies. However, there also exists conflicting evidence pointing to the potential neurotoxic effects of these intravenous anesthetics. The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized. Considering the mentioned above, this work aims to offer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system (CNS) and the peripheral nerve system (PNS) and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.