Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar
Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar
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DOI：
10.1093/bja/aet177
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发表时间：
2013-08-01
影响因子：
9.8
通讯作者：
Hemmings, H. C., Jr.
中科院分区：
文献类型：
--
作者：
Jevtovic-Todorovic, V.;Absalom, A. R.;Hemmings, H. C., Jr.
尽管以前被认为是完全可逆的，但全身麻醉现在被视为对两个极端年龄的认知能力都有潜在的重大风险。大量临床前以及一些回顾性临床证据表明，全身麻醉可能不利于年轻受试者的认知发展，也可能导致老年人认知能力加速下降。一组麻醉神经药理学和神经毒性专家在奥地利萨尔茨堡召开 BJA 萨尔茨堡麻醉神经毒性和神经可塑性研讨会。这个重点研讨会由《英国麻醉杂志》主办，旨在审查和严格评估当前来自动物和人类研究的现有证据，并考虑未来研究的方向。结论是，越来越多的临床前研究证据表明全身麻醉剂是神经元发育和功能的强大调节剂，可能导致有害的行为结果。然而，确切的临床数据仍然难以捉摸。由于无论患者年龄如何，全身麻醉通常都无法避免，因此了解麻醉引起的神经毒性的复杂机制和影响，并通过循证方法制定避免或限制潜在脑损伤的策略非常重要。
Although previously considered entirely reversible, general anaesthesia is now being viewed as a potentially significant risk to cognitive performance at both extremes of age. A large body of preclinical as well as some retrospective clinical evidence suggest that exposure to general anaesthesia could be detrimental to cognitive development in young subjects, and might also contribute to accelerated cognitive decline in the elderly. A group of experts in anaesthetic neuropharmacology and neurotoxicity convened in Salzburg, Austria for the BJA Salzburg Seminar on Anaesthetic Neurotoxicity and Neuroplasticity. This focused workshop was sponsored by the British Journal of Anaesthesia to review and critically assess currently available evidence from animal and human studies, and to consider the direction of future research. It was concluded that mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes. However, definitive clinical data remain elusive. Since general anaesthesia often cannot be avoided regardless of patient age, it is important to understand the complex mechanisms and effects involved in anaesthesia-induced neurotoxicity, and to develop strategies for avoiding or limiting potential brain injury through evidence-based approaches.