The Effect of N-Acetylcysteine on The Neurotoxicity of Sevoflurane in Developing Hippocampus Cells

Abstract Sevoflurane, a common pediatric anesthetic, has been linked to neurodegeneration, raising safety concerns. This study explored N-acetylcysteine's protective potential against sevoflurane-induced neurotoxicity in rat hippocampi. Four groups were examined: Control: Received 6 hours of 3 l/min gas (air and 30% O2) and intraperitoneal saline. NAC: Received 6 hours of 3 l/min gas and 150mg/kg NAC intraperitoneally. Sev: Exposed to 6 hours of 3 l/min gas and 3% sevoflurane. Sev+NAC: Received 6 hours of 3 l/min gas, 3% sevoflurane, and 150mg/kg NAC. Protein levels of NRF-2, NLRP3, IL-1β, caspase-1, Beclin 1, p62, LC3A, and apoptosis markers were assessed. Sevoflurane and NAC alone reduced autophagy, while Sev+NAC group maintained autophagy levels. Sev group had elevated NRF-2, NLRP3, pNRF2, Caspase-1, and IL-1β, which were reduced in Sev+NAC. Apoptosis was higher in Sev, but Sev+NAC showed reduced apoptosis compared to the control. In summary, sevoflurane induced neurotoxicity in developing hippocampus, which was mitigated by N-acetylcysteine administration.