Impact of anaesthetics and surgery on neurodevelopment: an update.
Br J Anaesth
; 110 Suppl 1: i53-72, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23542078
ABSTRACT
Accumulating preclinical and clinical evidence suggests the possibility of neurotoxicity from neonatal exposure to general anaesthetics. Here, we review the weight of the evidence from both human and animal studies and discuss the putative mechanisms of injury and options for protective strategies. Our review identified 55 rodent studies, seven primate studies, and nine clinical studies of interest. While the preclinical data consistently demonstrate robust apoptosis in the nervous system after anaesthetic exposure, only a few studies have performed cognitive follow-up. Nonetheless, the emerging evidence that the primate brain is vulnerable to anaesthetic-induced apoptosis is of concern. The impact of surgery on anaesthetic-induced brain injury has not been adequately addressed yet. The clinical data, comprising largely retrospective cohort database analyses, are inconclusive, in part due to confounding variables inherent in these observational epidemiological approaches. This places even greater emphasis on prospective approaches to this problem, such as the ongoing GAS trial and PANDA study.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encéfalo
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Lesões Encefálicas
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Anestésicos Gerais
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Síndromes Neurotóxicas
Tipo de estudo:
Prognostic_studies
Limite:
Animals
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Humans
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Newborn
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article