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European Archives of Paediatric Dentistry

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Open Access 22-04-2024 | Biomarkers | Original Scientific Article

Plasma neurological biomarkers as a measure of neurotoxicity in pediatric dental general anesthesia: a prospective observational feasibility study

Authors: S. Chakithandy, H. Nazzal, M. Matoug-Elwerfelli, S. Narasimhan, S. Uddin, K. S. Prabhu, L. Zarif, N. Mumtaz, A. Sharma, M. Al-Khelaifi

Published in: European Archives of Paediatric Dentistry | Issue 2/2024

Abstract

Purpose

Neurotoxicity concerns have been raised over general anesthesia and sedation medication use in children. Such concerns are largely based on animal studies, historical anesthetic agents, and assessment tools, thus warranting further investigations. Blood biomarkers in detecting neuronal inflammation and apoptosis are novel methods for detecting neuronal damage. Therefore, the aim of this feasibility study was to assess the usefulness of the levels of four plasma biomarkers in dental general anesthesia (DGA) as surrogate markers of neurotoxicity in children. The secondary aim was to compare changes in motor manipulative skills pre- and post-anesthetic exposure.

Methods

This single-center prospective observational study included 22 healthy children aged between 3 and 6 years old who underwent DGA. Subclinical neurotoxicity was measured with a panel of four plasma biomarkers: Caspase-3, neuron-specific enolase (NSE), neurofilament light chain, and S100B at three time points (1; at start, 2; end and 3; on recovery from DGA). The Skillings–Mack test was used to identify the difference in the biomarker levels at three time points. Motor manipulative score assessment, prior and two weeks after DGA was also performed.

Results

A total of 22 study participants (mean age = 5 ± 1 years) were included with a median DGA duration of 106 ± 28 min. A reduction in Caspase-3 levels was recorded, with pairwise comparison over three time points, reporting a statistical significance between time point 2 vs. 1 and time point 3 vs. 1. Although fluctuations in NSE levels were recorded, no significant changes were found following pairwise comparison analysis. Among other biomarkers, no significant changes over the three periods were recorded. Furthermore, no significant changes in manipulative motor scores were reported.

Conclusion

Caspase-3 reduced significantly in the short time frames during day-care DGA; this might be due to the relatively short anesthesia duration associated with dental treatment as compared with more extensive medical-related treatments. Therefore, further studies on Caspase-3 as a potential biomarker in pediatric DGA neurotoxicity are required to further ascertain results of this study.

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Title: Plasma neurological biomarkers as a measure of neurotoxicity in pediatric dental general anesthesia: a prospective observational feasibility study
Authors: S. Chakithandy
H. Nazzal
M. Matoug-Elwerfelli
S. Narasimhan
S. Uddin
K. S. Prabhu
L. Zarif
N. Mumtaz
A. Sharma
M. Al-Khelaifi
Publication date: 22-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Biomarkers
General Anesthesia
Pedodontics
Pedodontics
Published in: European Archives of Paediatric Dentistry / Issue 2/2024
Print ISSN: 1818-6300
Electronic ISSN: 1996-9805
DOI: https://doi.org/10.1007/s40368-024-00884-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Plasma neurological biomarkers as a measure of neurotoxicity in pediatric dental general anesthesia: a prospective observational feasibility study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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