Does Neuraxial Anesthesia as General Anesthesia Damage DNA? A Pilot Study in Patients Undergoing Orthopedic Traumatological Surgery

Kuchařová, Monika; Astapenko, David; Zubáňová, Veronika; Koščáková, M.; Štětina, Rudolf; Zadák, Z; Hronek, Miloslav

doi:10.3390/ijms21010084

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…The study by Kucharova et al [ 13 ] evaluated the genotoxic effects of anesthetic substances used for general anesthesia or neuraxial anesthesia treatments in a cohort of patients undergoing orthopedic traumatological surgery. The frequency of single-strand DNA breaks, oxidized pyrimidine bases and oxidized purine bases was measured by comet assay before and after anesthesia procedures.…”

mentioning

confidence: 99%

Oxidative Stress and DNA Damage in Chronic Disease and Environmental Studies

Peluso¹,

Russo²,

Mello

et al. 2020

IJMS

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mentioning

confidence: 99%

Oxidative Stress and DNA Damage in Chronic Disease and Environmental Studies

Peluso¹,

Russo²,

Mello

et al. 2020

IJMS

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“…Although SVAGs are not known as somatic mutagens and are not classified as carcinogens [ 54 ], it is known that the gases can cause significant increases in DNA damage in exposed somatic cells [ 55 , 56 ]. This phenomenon has been observed in studies of tissues both at the site of contact, e.g.…”

Section: Cellular Genetic and Epigenetic Toxicities Of Svagsmentioning

confidence: 99%

“…epithelial cells in the nose and bronchoalveolar cells [ 57 , 58 ] and systemically, e.g. peripheral blood lymphocytes (PBLs) [ 56 , 59–64 ] although those risks seem to be agent and dose/duration dependent [ 56 , 65 ]. GA waste gases are even seen to induce DNA damage in operating room personnel, with chronic exposure inducing cumulative genotoxic effects [ 66 , 67 ].…”

Section: Cellular Genetic and Epigenetic Toxicities Of Svagsmentioning

confidence: 99%

General anesthesia, germ cells and the missing heritability of autism: an urgent need for research

Escher¹,

Ford²

2020

Environmental Epigenetics

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Agents of general anesthesia (GA) are commonly employed in surgical, dental and diagnostic procedures to effectuate global suppression of the nervous system, but in addition to somatic targets, the subject’s germ cells—from the embryonic primordial stage to the mature gametes—may likewise be exposed. Although GA is generally considered safe for most patients, evidence has accumulated that various compounds, in particular the synthetic volatile anesthetic gases (SVAGs) such as sevoflurane, can exert neurotoxic, genotoxic and epigenotoxic effects, with adverse consequences for cellular and genomic function in both somatic and germline cells. The purpose of this paper is to review the evidence demonstrating that GA, and in particular, SVAGs, may in some circumstances adversely impact the molecular program of germ cells, resulting in brain and behavioral pathology in the progeny born of the exposed cells. Further, we exhort the medical and scientific communities to undertake comprehensive experimental and epidemiological research programs to address this critical gap in risk assessment.

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“…Additionally, NA is associated with reduced 30-day mortality risk for patients undergoing operations with moderate to high cardiac risk [ 9 ]. In addition, the previous study also demonstrated an increased risk of DNA damage after GA compared to NA [ 10 ].…”

Section: Introductionmentioning

confidence: 97%

Complications and Mortality after Surgeries in Patients with Prior Stroke Who Received General and Neuraxial Anesthesia: A Propensity-Score Matched Study

Kao

Chang

Yeh

et al. 2022

JCM

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Patients who previously suffered a stroke have increased risks of mortality and complications after surgeries, but the optimal anesthesia method is not fully understood. We aimed to compare the outcomes after surgeries for stroke patients who received general anesthesia (GA) and neuraxial anesthesia (NA). Using health insurance research data, we identified 36,149 stroke patients who underwent surgeries from 1 January 2008 to 31 December 2013. For balancing baseline covariates, the propensity-score-matching procedure was used to select adequate surgical patients who received GA and NA at a case–control ratio of 1:1. Multiple logistic regressions were applied to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative mortality and complications between surgical patients with prior stroke who received GA and NA. Among the 4903 matched pairs with prior stroke, patients with GA had higher risks of pneumonia (OR 2.00, 95% CI 1.62–2.46), pulmonary embolism (OR 3.30, 95% CI 1.07–10.2), acute renal failure (OR 3.51, 95% CI 1.13–2.10), intensive care unit stay (OR 3.74, 95% CI 3.17–4.41), and in-hospital mortality (OR 2.02, 95% CI 1.16–3.51) than those who received NA. Postoperative adverse events were associated with GA in patients aged more than 60 years and those who received digestive surgery (OR 3.11, 95% CI 2.08–4.66). We found that stroke patients undergoing GA had increased postoperative complications and mortality after surgery compared with those who received NA. However, these findings need more validation and evaluation by clinical trials.

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Does Neuraxial Anesthesia as General Anesthesia Damage DNA? A Pilot Study in Patients Undergoing Orthopedic Traumatological Surgery

Cited by 4 publications

References 40 publications

Oxidative Stress and DNA Damage in Chronic Disease and Environmental Studies

Oxidative Stress and DNA Damage in Chronic Disease and Environmental Studies

General anesthesia, germ cells and the missing heritability of autism: an urgent need for research

Complications and Mortality after Surgeries in Patients with Prior Stroke Who Received General and Neuraxial Anesthesia: A Propensity-Score Matched Study

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