Impact of sevoflurane anesthesia on S-adenosylmethionine in neonates under general anesthesia.

Background and aims: Preclinical studies in rodents and primates have shown that anesthesia was neurotoxic to the developing brain after exposure in the neonatal period. Sevoflurane a commonly used inhalational anesthetic, especially in pediatric surgery, might cause behavioral impairment in the developing brain. Although favored for its rapid onset and minimal airway disturbance, sevoflurane has been implicated in neurotoxic effects such as anesthesia-induced developmental neurotoxicity in rodents, through various mechanisms. One of the mechanisms was disturbances in methylation metabolism which can be easily treated if it is proved. This study aims to evaluate the levels of S-adenosylmethionine [SAM] following sevoflurane anesthesia in neonates and to correlate the duration of sevoflurane exposure and S-adenosylmethionine levels.

Material and methods: Sixty neonates were included in the study under general anesthesia. Pre- and postsevoflurane exposure arterial blood samples were collected in ethylenediamine tetraacetic acid vacutainers. Each sample was centrifuged at 1000 rpm for 10 min. Plasma was separated and stored at -80°C, then subjected to S-adenosylmethionine enzyme-linked immunoassay test for preand postsevoflurane exposure levels of SAM.

Results: The difference between the pre- and post-SAM values is not statistically significant and also with increasing the duration of sevoflurane exposure there was no reduction in the SAM levels (r = 0.17), and the correlation was not significant (P = 0.18).

Conclusion: Single exposure to sevoflurane does not impact SAM levels in neonates undergoing general anesthesia.