General Anesthesia and Young Brain: What is New?
General Anesthesia and Young Brain: What is New?
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DOI：
10.1097/ana.0000000000000432
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发表时间：
2018-07
影响因子：
3.7
通讯作者：
Brambrick A
中科院分区：
文献类型：
--
作者：
Jevtovic-Todorovic V;Brambrick A
考虑到每年有越来越多的幼儿接受全身麻醉，了解这种做法如何以及是否会影响他们非常不成熟和脆弱的大脑的发育和发育是至关重要的。来自动物研究的令人信服的证据表明，早期暴露在全身麻醉下会损害正常的大脑发育，导致神经元和神经胶质细胞的结构和功能损伤，并对正常的情感和认知发育造成长期的损害。尽管来自动物研究的证据是压倒性的，并在从啮齿动物到非人类灵长类动物的各种物种中得到证实，但来自人类研究的证据目前是不一致的，也不是决定性的。在这篇综述中，我们重点介绍了麻醉诱导的发育神经毒性的动物研究的新进展，并总结了最近的临床研究，同时重点介绍了结果测量和暴露变量对评估儿童认知和行为发育的效用。
Considering that growing population of very young children is exposed to general anesthesia every year, it is of utmost importance to understand how and whether such practice may affect the development and growth of their very immature and vulnerable brains. Compelling evidence from animal studies suggests that an early exposure to general anesthesia is detrimental to normal brain development leading to structural and functional impairments of neurons and glia, and long-lasting impairments in normal emotional and cognitive development. Although the evidence from animal studies is overwhelming and confirmed across species examined from rodents to non-human primates, the evidence from human studies is inconsistent and not conclusive at present. In this review we focus on new developments in animal studies of anesthesia-induced developmental neurotoxicity and summarize recent clinical studies while focusing on outcome measures and exposure variables in terms of their utility for assessing cognitive and behavioral development in children.