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临床神经毒性研究更新会议总结

Summary of the Update Session on Clinical Neurotoxicity Studies.

作者信息

Pinyavat Teeda, Warner David O, Flick Randall P, McCann Mary Ellen, Andropoulos Dean B, Hu Danquig, Sall Jeffrey W, Spann Marisa N, Ing Caleb

机构信息

Departments of *Anesthesiology#Psychiatry, Columbia University College of Physicians and Surgeons, New York, NYDepartments of †Anesthesiology‡Pediatrics, Mayo Clinic College of Medicine, Rochester, MN§Department of Anesthesiology, Harvard Medical School, Boston, MA∥Department of Anesthesiology and Department of Pediatrics, Baylor College of Medicine, Houston, TX¶Department of Anesthesiology and Perioperative Care, University of California San Francisco School of Medicine, San Francisco, CA.

出版信息

J Neurosurg Anesthesiol. 2016 Oct;28(4):356-360. doi: 10.1097/ANA.0000000000000347.

DOI:10.1097/ANA.0000000000000347
PMID:27768673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5077165/
Abstract

During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study. The purpose of this summary is to discuss the contributions and limitations of these studies, how they fit into the published literature, and what questions remain to be answered.

摘要

在第五届儿科麻醉神经发育评估研讨会上,专家和利益相关者齐聚一堂,介绍并讨论了婴幼儿接触麻醉药物后神经发育结局研究的最新进展。本文总结了5项正在进行的临床研究的最新情况:全身麻醉与脊髓麻醉的比较、瑞芬太尼和右美托咪定的毒性、梅奥儿童麻醉安全性研究、加利福尼亚大学旧金山分校人类队列研究以及哥伦比亚大学医学中心新生儿磁共振成像研究。本总结的目的是讨论这些研究的贡献与局限性、它们如何融入已发表的文献以及仍有待解答的问题。

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本文引用的文献

1
Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.婴儿期全身麻醉与清醒区域麻醉后2岁时的神经发育结局(GAS):一项国际多中心随机对照试验。
Lancet. 2016 Jan 16;387(10015):239-50. doi: 10.1016/S0140-6736(15)00608-X. Epub 2015 Nov 4.
2
Dexmedetomidine as a Rapid Bolus for Treatment and Prophylactic Prevention of Emergence Agitation in Anesthetized Children.右美托咪定作为快速推注药物用于治疗和预防性预防麻醉儿童的苏醒期躁动。
Anesth Analg. 2015 Nov;121(5):1308-15. doi: 10.1213/ANE.0000000000000931.
3
Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial.婴儿清醒区域麻醉和全身麻醉后的呼吸暂停:全身麻醉与脊髓麻醉比较研究——比较呼吸暂停和神经发育结局,一项随机对照试验
Anesthesiology. 2015 Jul;123(1):38-54. doi: 10.1097/ALN.0000000000000709.
4
Anesthetic neurotoxicity--clinical implications of animal models.麻醉神经毒性——动物模型的临床意义。
N Engl J Med. 2015 Feb 26;372(9):796-7. doi: 10.1056/NEJMp1414786.
5
Morphological features of the neonatal brain following exposure to regional anesthesia during labor and delivery.分娩过程中接受区域麻醉后新生儿大脑的形态学特征。
Magn Reson Imaging. 2015 Feb;33(2):213-21. doi: 10.1016/j.mri.2014.08.033. Epub 2014 Aug 30.
6
Neurodevelopmental outcomes after initial childhood anesthetic exposure between ages 3 and 10 years.3 至 10 岁儿童初次麻醉暴露后的神经发育结局。
J Neurosurg Anesthesiol. 2014 Oct;26(4):377-86. doi: 10.1097/ANA.0000000000000121.
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Effect of general anesthesia in infancy on long-term recognition memory in humans and rats.婴儿期全身麻醉对人类和大鼠长期识别记忆的影响。
Neuropsychopharmacology. 2014 Sep;39(10):2275-87. doi: 10.1038/npp.2014.134. Epub 2014 Jun 9.
8
Comparison of propofol and dexmedetomedine techniques in children undergoing magnetic resonance imaging.丙泊酚与右美托咪定用于儿童磁共振成像的技术比较
Paediatr Anaesth. 2014 Aug;24(8):813-8. doi: 10.1111/pan.12408. Epub 2014 May 12.
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Comparative analysis of outcome measures used in examining neurodevelopmental effects of early childhood anesthesia exposure.比较分析用于检查儿童早期麻醉暴露对神经发育影响的结局评估指标。
Anesthesiology. 2014 Jun;120(6):1319-32. doi: 10.1097/ALN.0000000000000248.
10
A phase II/III, multicenter, safety, efficacy, and pharmacokinetic study of dexmedetomidine in preterm and term neonates.一项关于右美托咪定在早产儿和足月儿中的 II/III 期、多中心、安全性、有效性和药代动力学研究。
J Pediatr. 2014 Feb;164(2):276-82.e1-3. doi: 10.1016/j.jpeds.2013.10.002. Epub 2013 Nov 14.