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Int J Dev Neurosci. 2014 Oct;37:87-93. doi: 10.1016/j.ijdevneu.2014.06.016. Epub 2014 Jul 5.

Effect of combining anesthetics in neonates on long-term cognitive function.

Author information

  • 1Department of Anesthesia and Perioperative Care, University of California San Francisco, United States.
  • 2University of California San Francisco School of Pharmacy, United States.
  • 3Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • 4Keck School of Medicine of USC, United States.
  • 5Arizona College of Osteopathic Medicine, United States.
  • 6University of Arizona College of Medicine, United States.
  • 7Department of Anesthesia and Perioperative Care, University of California San Francisco, United States. Electronic address:



With growing evidence that anesthesia exposure in infancy affects cognitive development, it is important to understand how distinct anesthetic agents and combinations can alter long-term memory. Investigations of neuronal death suggest that combining anesthetic agents increases the extent of neuronal injury. However, it is unclear how the use of simultaneously combined anesthetics affects cognitive outcome relative to the use of a single agent.


Postnatal day 7 (P7) male rats were administered either sevoflurane as a single agent or the combined delivery of sevoflurane with nitrous oxide at 1 Minimum Alveolar Concentration for 4 h. Behavior was assessed in adulthood using the forced alternating T-maze, social recognition, and context-specific object recognition tasks.


Animals exposed to either anesthetic were unimpaired in the forced alternating T-maze test and had intact social recognition. Subjects treated with the combined anesthetic displayed a deficit, however, in the object recognition task, while those treated with sevoflurane alone were unaffected.


A combined sevoflurane and nitrous oxide anesthetic led to a distinct behavioral outcome compared with sevoflurane alone, suggesting that the simultaneous use of multiple agents may uniquely influence early neural and cognitive development and potentially impacts associative memory.

Published by Elsevier Ltd.


Memory; Neurotoxicity; Sevoflurane+/−nitrous oxide; Volatile anesthetics

[PubMed - indexed for MEDLINE]
[Available on 2015-10-01]
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