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全身麻醉对大脑的持久影响:机制与相关性。

Lasting impact of general anaesthesia on the brain: mechanisms and relevance.

机构信息

Department of Anesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva 4, Switzerland.

Department of Basic Neuroscience, University of Geneva Medical School, 1 rue Michel Servet, 1211 Geneva 4, Switzerland.

出版信息

Nat Rev Neurosci. 2016 Oct 18;17(11):705-717. doi: 10.1038/nrn.2016.128.

Abstract

General anaesthesia is usually considered to safely induce a reversible brain state allowing the performance of surgery under optimal conditions. An increasing number of clinical and experimental observations, however, suggest that anaesthetic drugs, especially when they are administered at the extremes of age, can trigger long-term morphological and functional alterations in the brain. Here, we review available mechanistic data linking general-anaesthesia exposure to impaired cognitive performance in both young and mature nervous systems. We also provide a critical appraisal of the translational value of animal models and highlight the important challenges that need to be addressed to strengthen the link between laboratory work and clinical investigations in the field of anaesthesia-neurotoxicity research.

摘要

全身麻醉通常被认为可以安全地诱导可逆性脑状态,从而在最佳条件下进行手术。然而,越来越多的临床和实验观察表明,麻醉药物,尤其是在儿童和老年人中使用时,可能会引发大脑的长期形态和功能改变。在这里,我们回顾了现有的机制数据,这些数据将全身麻醉暴露与年轻和成熟神经系统中认知表现受损联系起来。我们还对动物模型的转化价值进行了批判性评估,并强调了需要解决的重要挑战,以加强实验室工作与麻醉神经毒性研究领域临床研究之间的联系。

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