Biddle Chuck, Ford Vincent
Annu Rev Nurs Res. 2017 Jan;35(1):201-219. doi: 10.1891/0739-6686.35.201.
A substantial body of research suggests that anesthetic exposure to patients who are very young or very old may impair cognitive, behavioral, and emotional development or recovery. In lower animal models of pre- and postnatal age, anesthetic exposure may impact inflammation, synaptogenesis, neuronal apoptosis, and glial cell development. To date, research in humans is inconclusive regarding the long-term cognitive and behavioral sequelae of general anesthesia in the young child. In older adults, postoperative cognitive dysfunction and cognitive delirium are identified as markers of anesthetic neurotoxicity. Existing neurological degenerative processes and other comorbidities in combination with the stress of surgery make evaluating the independent impact of anesthetic exposure difficult. Advances in research, imaging, and partnerships have enhanced the potential for understanding the impact of anesthetic exposure. In both populations, the resulting data and limitations faced in initial research efforts are catalysts for current prospective studies.
大量研究表明，对非常年幼或非常年老的患者进行麻醉可能会损害其认知、行为和情感发展或恢复。在产前和产后年龄的低等动物模型中，麻醉暴露可能会影响炎症、突触形成、神经元凋亡和胶质细胞发育。迄今为止，关于幼儿全身麻醉的长期认知和行为后遗症，人类研究尚无定论。在老年人中，术后认知功能障碍和认知谵妄被视为麻醉神经毒性的标志。现有的神经退行性过程和其他合并症，再加上手术应激，使得评估麻醉暴露的独立影响变得困难。研究、成像技术以及合作方面的进展增强了理解麻醉暴露影响的可能性。在这两个人群中，初步研究工作所产生的数据和面临的局限性都是当前前瞻性研究的催化剂。
