Neonatal Pain, Opioid, and Anesthetic Exposure; What Remains in the Human Brain After the Wheels of Time?
Neonatal Pain, Opioid, and Anesthetic Exposure; What Remains in the Human Brain After the Wheels of Time?
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DOI：
10.3389/fped.2022.825725
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发表时间：
2022
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
--
作者：
评估新生儿接触疼痛、阿片类药物和麻醉药对儿童和青少年可能产生的长期负面影响。我们研究了五组独特的儿童，这些儿童来自有良好记录的新生儿队列，他们有新生儿接触疼痛、阿片类药物或麻醉药的历史，从没有疼痛到剧烈疼痛，从没有阿片类药物暴露到有或没有麻醉药的情况下，从没有阿片类药物暴露到非常高的阿片类药物暴露。我们评估了接受大手术(组1和2)、体外膜氧合(组3)、早产(组4)和产前阿片类药物暴露(组5)的儿童与健康对照组相比。评估了疼痛期间的神经心理功能、温度检测和痛阈值以及高分辨率结构和基于任务的功能磁共振成像。总共纳入了94例患者，并与他们自己的对照组进行了比较。组3和组5的儿童和青少年在高阿片类药物暴露后神经心理功能较差。与对照组相比，组1(疼痛、阿片类药物和麻醉剂暴露)仅在左侧嘴中额叶皮质有较厚的皮质。我们发现，在其他组和他们的对照组之间，与疼痛相关的大脑区域的其他脑体积、痛阈值或疼痛期间的脑活动没有差异。除了阿片类药物暴露程度最高的人群的神经心理影响值得进一步研究外，在生命早期暴露8-19年后，没有观察到新生儿疼痛、阿片类药物或麻醉剂暴露的重大影响。需要更大样本量的研究来证实我们的发现，并测试暴露在暴露和未暴露的儿童之间不那么明显的差异。
To evaluate possible negative long-term effects of neonatal exposure to pain, opioids and anesthetics in children and adolescents. We studied five unique groups of children recruited from well-documented neonatal cohorts with a history of neonatal exposure to pain, opioids or anesthetics at different points along the continuum from no pain to intense pain and from no opioid exposure to very high opioid exposure in the presence or absence of anesthetics. We evaluated children who underwent major surgery (group 1 and 2), extracorporeal membrane oxygenation (group 3), preterm birth (group 4) and prenatal opioid exposure (group 5) in comparison to healthy controls. Neuropsychological functioning, thermal detection and pain thresholds and high-resolution structural and task-based functional magnetic resonance imaging during pain were assessed. In total 94 cases were included and compared to their own control groups. Children and adolescents in groups 3 and 5 showed worse neuropsychological functioning after high opioid exposure. A thicker cortex was found in group 1 (pain, opioid and anesthetic exposure) in only the left rostral-middle-frontal-cortex compared to controls. We found no differences in other brain volumes, pain thresholds or brain activity during pain in pain related brain regions between the other groups and their controls. No major effects of neonatal pain, opioid or anesthetic exposure were observed in humans 8–19 years after exposure in early life, apart from neuropsychological effects in the groups with the highest opioid exposure that warrants further investigation. Studies with larger sample sizes are needed to confirm our findings and test for less pronounced differences between exposed and unexposed children.
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影响因子：
2.5
作者：
Duehrsen, Lasse;Simons, Sinno H. P.;Felderhoff-Mueser, Ursula
通讯作者：
Felderhoff-Mueser, Ursula
DOI：
10.1016/s0140-6736(15)00608-x
发表时间：
2016-01-16
期刊：
Lancet (London, England)
影响因子：
--
作者：
Davidson AJ;Disma N;de Graaff JC;Withington DE;Dorris L;Bell G;Stargatt R;Bellinger DC;Schuster T;Arnup SJ;Hardy P;Hunt RW;Takagi MJ;Giribaldi G;Hartmann PL;Salvo I;Morton NS;von Ungern Sternberg BS;Locatelli BG;Wilton N;Lynn A;Thomas JJ;Polaner D;Bagshaw O;Szmuk P;Absalom AR;Frawley G;Berde C;Ormond GD;Marmor J;McCann ME;GAS consortium
通讯作者：
GAS consortium
影响因子：
7.6
作者：
Gu, Chaoliang;Li, Peng;Hu, Xintian
通讯作者：
Hu, Xintian
影响因子：
2.6
作者：
Kasala S;Briyal S;Prazad P;Ranjan AK;Stefanov G;Donovan R;Gulati A
通讯作者：
Gulati A
影响因子：
168.9
作者：
Anand, KJS;Hall, RW;Barton, BA
通讯作者：
Barton, BA