Nemergut Michael E, Aganga Devon, Flick Randall P
Departments of Anesthesiology and Pediatric and Adolescent Medicine, The Mayo Clinic, Rochester, MN, USA.
Paediatr Anaesth. 2014 Jan;24(1):120-6. doi: 10.1111/pan.12325. Epub 2013 Nov 27.
Over the past decade, numerous preclinical and retrospective human studies have reported that the provision of anesthetic and sedative agents to infants and children may be associated with adverse neurodevelopmental outcomes. These data have gained widespread attention from professional and regulatory agencies, including the public at large. As such, pediatric anesthesiologists are being increasingly questioned by parents about the risks of anesthetic agents on their children's neurocognitive development. To impart a framework from which anesthesiologists may address the apprehensions of parents who actively bring up this issue, we review the data supporting anesthetic neurotoxicity and discuss its strengths and limitations. As many parents are not yet aware and do not actively raise these concerns, we also discuss whether such a conversation should be undertaken as a part of the consent process.
在过去十年中，大量临床前研究和回顾性人体研究报告称，给婴幼儿和儿童使用麻醉剂和镇静剂可能会导致不良的神经发育结果。这些数据受到了包括广大公众在内的专业和监管机构的广泛关注。因此，儿科麻醉医生越来越多地被家长问及麻醉剂对其子女神经认知发育的风险。为了提供一个框架，以便麻醉医生能够应对积极提出这个问题的家长的担忧，我们回顾了支持麻醉神经毒性的数据，并讨论了其优势和局限性。由于许多家长尚未意识到且未主动提出这些担忧，我们还讨论了是否应在知情同意过程中进行这样的对话。
