大脑发育和全身麻醉——有什么值得关注的吗?

Vesna Jevtovic-Todorovic
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引用次数: 11

摘要

对生病的早产儿和非常年幼的儿童的熟练管理导致他们的大脑大量暴露于各种麻醉剂中,这些麻醉剂旨在达到完全丧失意识和对疼痛不敏感所需的大量神经元抑制深度。不幸的是,我们最近的动物研究结果表明,常用的全身麻醉剂会损害发育中的神经元,并导致大脑脆弱区域的显著神经元缺失。此外,新出现的动物和人类数据表明,早期接受全身麻醉与认知发育的长期损害之间存在关联。因此,对这一人群进行频繁麻醉暴露的谨慎性现在正在被仔细审查。值得注意的是,根据目前可获得的信息,关于动物研究结果的临床相关性,仍然存在相当大的意见分歧。由于没有足够的证据在动物和人类的发现之间建立明确的联系,因此建议当前临床实践的重大变化还为时过早。
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Developing brain and general anesthesia - is there a cause for concern?

Skilled management of sick premature babies and very young children has resulted in numerous exposures of their brains to a variety of anesthetic agents designed to achieve the substantial depth of neuronal inhibition required for complete loss of consciousness and insensitivity to pain. Unfortunately, our recent animal findings suggest that commonly used general anesthetics are damaging to developing neurons and cause significant neuronal deletion in vulnerable brain regions. In addition, emerging animal and human data suggest an association between early exposure to general anesthesia and long-term impairment of cognitive development. Consequently, the prudence of frequent anesthesia exposure of this population is now being scrutinized. It is important to note that on the basis of currently available information, there are still considerable differences of opinion regarding the clinical relevance of the animal findings. Since there is insufficient evidence establishing a clear association between animal and human findings, it would be premature to suggest major changes in current clinical practice.

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