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Gender-Specific Differences in the Central Nervous System’s Response to Anesthesia

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Abstract

Males and females are physiologically distinct in their responses to various anesthetic agents. The brain and central nervous system (CNS), the main target of anesthesia, are sexually dimorphic from birth and continue to differentiate throughout life. Accordingly, gender has a substantial impact on the influence of various anesthetic agents in the brain and CNS. Given the vast differences in the male and female CNS, it is surprising to find that females are often excluded from basic and clinical research studies of anesthesia. In animal research, males are typically studied to avoid the complication of breeding, pregnancy, and hormonal changes in females. In clinical studies, females are also excluded for the variations that occur in the reproductive cycle. Being that approximately half of the surgical population is female, the exclusion of females in anesthesia-related research studies leaves a huge knowledge gap in the literature. In this review, we examine the reported sex-specific differences in the central nervous system’s response to anesthesia. Furthermore, we suggest that anesthesia researchers perform experiments on both sexes to further evaluate such differences. We believe a key goal of research studying the interaction of the brain and anesthesia should include the search for knowledge of sex-specific mechanisms that will improve anesthetic care and management in both sexes.

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Acknowledgments

The authors extend a note of appreciation to Eric Shaw and Dr. Dalton Dietrich for the critical review of this manuscript and helpful discussion. The authors regret space limitations that prevented the citation of many noteworthy and relevant studies. The support for the authors’ work and laboratories was from The Miami Project to Cure Paralysis and Department of Anesthesiology at the University of Miami Miller School of Medicine.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Lois Pope LIFE Center, 1095 N.W. 14th Terrace (R-48), Miami, FL, 33136-1060, USA

    Lana J. Mawhinney

  2. College of Arts and Science, University of Miami, Miami, FL, USA

    Davita Mabourakh

  3. Graduate Medical Education, University of Miami Miller School of Medicine, Miami, FL, USA

    Michael C. Lewis

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  1. Lana J. Mawhinney
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  2. Davita Mabourakh
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  3. Michael C. Lewis
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Correspondence to Lana J. Mawhinney.

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Mawhinney, L.J., Mabourakh, D. & Lewis, M.C. Gender-Specific Differences in the Central Nervous System’s Response to Anesthesia. Transl. Stroke Res. 4, 462–475 (2013). https://doi.org/10.1007/s12975-012-0229-y

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  • DOI: https://doi.org/10.1007/s12975-012-0229-y

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