Brambrink Ansgar M, Orfanakis Andrea, Kirsch Jeffrey R
Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
Anesthesiol Clin. 2012 Jun;30(2):207-28. doi: 10.1016/j.anclin.2012.06.002.
Concerns for toxic effects of anesthesia to the brains of the young and the elderly are mounting. While experimental evidence for such effects in the developing brain is strong, the underlying mechanisms are less well understood and debate continues as to whether young humans are at risk for anesthetic neurotoxicity. The phenomenon of postoperative cognitive deterioration in the elderly remains controversial. Time course, severity, and whether or not it persists long term are under debate. For both patient groups, today's evidence is not sufficient to guide change in clinical practice. Well-designed research is therefore imperative to tackle this critical issue.
对麻醉对年轻人和老年人大脑产生毒性作用的担忧日益增加。虽然在发育中的大脑中存在此类作用的实验证据确凿，但潜在机制却鲜为人知，关于年轻人类是否存在麻醉神经毒性风险的争论仍在继续。老年人术后认知功能恶化的现象仍存在争议。其时间进程、严重程度以及是否会长期持续仍在争论之中。对于这两类患者群体而言，目前的证据不足以指导临床实践的改变。因此，必须开展精心设计的研究来解决这一关键问题。
