Abstract

Neurocognitive deficits arising from anesthetic exposure have recently been debated, while studies have shown that the phosphorylation of cyclic AMP response element-binding protein (CREB) in the hippocampus is critical for long-term memory. To better understand the neural effects of inhalational anesthetics, we studied the behavioral and biochemical changes in aged rats that were exposed to sevoflurane (Sev) and nitrous oxide (N2O) for 4 h. Eighteen-month-old rats were randomly assigned to receive 1.3% sevoflurane and 50% nitrous oxide/50% oxygen or 50% oxygen for 4 h. Spatial learning and memory were tested with the Morris water maze 48 h after exposure, and the results showed that sevoflurane–nitrous oxide exposure induced a significant deficit in spatial learning acquisition and memory retention. Experiments revealed that the cAMP and pCREB levels in the dorsal hippocampus were decreased in rats with anesthetic exposure in comparison with control rats 48 h after anesthesia as well as 15 min after the probe trial, but there were no significant differences in CREB expression. Besides these, the current study also found the DG neurogenesis significantly decreased as well as neuronal loss and neuronal apoptosis increased in the hippocampus of rats exposed to Sev+N2O. The current study demonstrated that down-regulation of cAMP/CREB signaling, decrease of CREB-dependent neurogenesis and neuronal survival in the hippocampus contributed to the neurotoxicity and cognitive dysfunction induced by general anesthesia with sevoflurane–nitrous oxide.

Highlights

  • The combination of sevoflurane with nitrous oxide is widely used in clinical anesthesia practice

  • To understand whether Cyclic AMP (cAMP)/Phosphorylation/activation of CREB (pCREB) down-regulation affect the neuronal survival after Sev+N2O anesthesia, we evaluated the neuronal survival by Nissl staining and NeuN staining

  • We examined the possibility that the spatial learning and memory impairments in aged rats after general anesthesia with Sev+N2O might be related to a deficiency in DG neurogenesis due to the downregulation of cAMP/pCREB

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Summary

Introduction

The combination of sevoflurane with nitrous oxide is widely used in clinical anesthesia practice. Studies indicated that general anesthesia with a combination of nitrous oxide (N2O) and isoflurane (ISO) or sedation with 70% N2O produced lasting impairment in spatial working memory in rats [4,5,6,7,8]. Exposure of neonatal mice to inhaled sevoflurane caused persistent learning deficits in fear conditioning later in adulthood, and abnormal social behaviors resembling autism spectrum disorder [9]. Such exposure induced apoptosis, increased beta-amyloid protein levels [1] and tau phosphorylation through activation of specific kinases, which is considered a potential mechanism of cognitive dysfunction caused by anesthesia [10]. Detrimental effects of anesthetics on cognitive function have been reported, to our knowledge, no study has investigated the effects of the anesthetic sevoflurane combined with N2O on spatial learning and memory in aged rats

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