Weber Frank, Van Beek Stefan, Scoones Gail
Department of Anesthesia, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands -
Minerva Anestesiol. 2016 Mar;82(3):294-300. Epub 2015 Sep 3.
Potential neurotoxicity of anesthetic drugs is currently one of the most intensely discussed issues in pediatric anesthesia. Prospective human data are sorely lacking and there is an on-going debate among experts in the field whether one should (or can) extrapolate animal data to humans. Data regarding the thoughts of practicing anesthetists regarding this topic have not been published.
A web-based survey to assess the thoughts of practicing (European) anesthetists regarding neurotoxicity and how it may have influenced their daily practice of pediatric anesthesia.
The majority (68.7%) of respondents regard neurotoxicity as an important topic, which they need to further explore. Two thirds have already changed their clinical practice and 44.3% were concerned about potential neurotoxicity. Anesthetists from children's hospitals were less likely to routinely inform parents about neurotoxicity (P=0.005) and more often applied an opioid-only anesthesia technique in selected premature neonates than general hospital based anesthetists (P<0.0001). Prospective human longitudinal studies focusing on neurodevelopment were given the highest priority for future research, whereas animal studies scored lowest.
Practicing anesthetists care about potential neurotoxicity of anesthetic drugs in young children. Colleagues working in children's hospital have slightly different attitudes to deal with the topic, compared to those working in general hospitals. The vast majority of our colleagues are waiting for prospective human research data that may help to unravel the current controversy surrounding potential anesthetic drug neurotoxicity and help to improve the safety of pediatric anesthesia.
麻醉药物潜在的神经毒性是目前小儿麻醉领域讨论最为激烈的问题之一。前瞻性人体数据严重匮乏，该领域专家对于是否应该（或能够）将动物数据外推至人类存在持续的争论。关于执业麻醉医生对该主题看法的数据尚未发表。
开展一项基于网络的调查，以评估执业（欧洲）麻醉医生对神经毒性的看法以及其如何影响他们小儿麻醉的日常实践。
大多数（68.7%）受访者认为神经毒性是一个重要主题，他们需要进一步探索。三分之二的人已经改变了他们的临床实践，44.3%的人担心潜在的神经毒性。儿童医院的麻醉医生不太可能定期告知家长神经毒性相关情况（P = 0.005），并且在选定的早产儿中，与综合医院的麻醉医生相比，他们更常采用仅使用阿片类药物的麻醉技术（P < 0.0001）。未来研究中，聚焦神经发育的前瞻性人体纵向研究被赋予最高优先级，而动物研究得分最低。
执业麻醉医生关注幼儿麻醉药物潜在的神经毒性。与综合医院的同事相比，儿童医院的同事在处理该主题时态度略有不同。我们绝大多数同事都在等待前瞻性人体研究数据，这些数据可能有助于解开当前围绕麻醉药物潜在神经毒性的争议，并有助于提高小儿麻醉的安全性。
