Association between anesthetics and autism spectrum disorder: from bench to bedside
- PMID: 40456945
- DOI: 10.1007/s00540-025-03519-5
Association between anesthetics and autism spectrum disorder: from bench to bedside
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms of impaired social communication and stereotyped behaviors. While early-life exposure to anesthetics may increase the risk of ASD, anesthetics can also have therapeutic effects on ASD, potentially through mechanisms involving the N-methyl-D-aspartate (NMDA) receptor, gamma-aminobutyric acid (GABA)ergic, and µ-opioid receptor signaling pathways. Given that individuals with ASD often exhibit high levels of non-cooperation and poor communication abilities, they typically require deeper sedation during medical examinations, making the choice of anesthetics particularly critical. This article provides an overview about the effects and underlying mechanisms of various anesthetics with ASD, aiming to assist anesthesiologists in implementing anesthesia management for ASD patients more scientifically.
Keywords: Anesthesia management; Anesthetics; Autism spectrum disorder; Benzodiazepines; Opioids.
© 2025. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.
Conflict of interest statement
Declarations. Conflict of interests: The authors declare that they have no conflict of interest. Therefore, a data availability statement is not applicable.
References
-
- Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018;392(10146):508–20. https://doi.org/10.1016/s0140-6736(18)31129-2 . - DOI - PubMed - PMC
-
- Hirota T, King BH. Autism spectrum disorder: a review. JAMA. 2023;329(2):157–68. https://doi.org/10.1001/jama.2022.23661 . - DOI - PubMed
-
- Takahashi N, Harada T, Nishimura T, Okumura A, Choi D, Iwabuchi T, Kuwabara H, Takagai S, Nomura Y, Takei N, Tsuchiya KJ. Association of genetic risks with autism spectrum disorder and early neurodevelopmental delays among children without intellectual disability. JAMA Netw Open. 2020;3(2): e1921644. https://doi.org/10.1001/jamanetworkopen.2019.21644 . - DOI - PubMed - PMC
-
- Burnashev N, Szepetowski P. NMDA receptor subunit mutations in neurodevelopmental disorders. Curr Opin Pharmacol. 2015;20:73–82. https://doi.org/10.1016/j.coph.2014.11.008 . - DOI - PubMed
-
- Rueda-Ruzafa L, Cruz F, Cardona D, Hone AJ, Molina-Torres G, Sánchez-Labraca N, Roman P. Opioid system influences gut–brain axis: dysbiosis and related alterations. Pharmacol Res. 2020;159: 104928. https://doi.org/10.1016/j.phrs.2020.104928 . - DOI - PubMed
Publication types
LinkOut - more resources
Full Text Sources