Terushkin Vitaly, Brauer Jeremy, Bernstein Leonard, Geronemus Roy
*The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York; †Laser & Skin Surgery Center of New York, New York, New York.
Dermatol Surg. 2017 Apr;43(4):534-540. doi: 10.1097/DSS.0000000000001003.
Multiple exposures to general anesthesia may be neurotoxic to the developing brain. This relationship has not been evaluated in children undergoing laser surgery for vascular anomalies.
To evaluate the prevalence of neurodevelopmental abnormalities in children who received multiple laser procedures under general anesthesia before the age of 4 years for the treatment of vascular anomalies.
Retrospective chart review of patients with contact of parents for telephone interview.
Thirty-three patients were eligible. Average age at the time of survey was 7.8 years. Twenty-three (84.8%) patients were female, with average age at the time of first treatment at 1.9 years. Average number of treatments received before the age of 4 years was 6.7. Anesthetics included inhalational nitrous oxide and isoflurane and intravenous propofol. Seven patients carried one or more of the following diagnoses: attention-deficit hyperactivity disorder (3.0%), anxiety (6.1%), behavioral disorder (3.0%), language disorder (3.0%), speech disorder (3.0%), and motor disorder (6.1%). These prevalence rates are similar to those found in the US population.
This is the first report on the prevalence of neurodevelopmental disorders in children undergoing multiple laser treatments under general anesthesia. Although the study sample is small, no increased risks when comparing with prevalence rates reported in the literature were noted.
多次接受全身麻醉可能对发育中的大脑具有神经毒性。这种关系尚未在接受激光手术治疗血管异常的儿童中进行评估。
评估4岁前接受多次全身麻醉下激光手术治疗血管异常的儿童中神经发育异常的患病率。
对患者病历进行回顾性审查,并与家长联系进行电话访谈。
33例患者符合条件。调查时的平均年龄为7.8岁。23例(84.8%)为女性,首次治疗时的平均年龄为1.9岁。4岁前接受治疗的平均次数为6.7次。麻醉剂包括吸入性一氧化二氮、异氟烷和静脉注射丙泊酚。7例患者有一种或多种以下诊断:注意力缺陷多动障碍(3.0%)、焦虑症(6.1%)、行为障碍(3.0%)、语言障碍(3.0%)、言语障碍(3.0%)和运动障碍(6.1%)。这些患病率与美国人群中的患病率相似。
这是关于接受多次全身麻醉下激光治疗的儿童中神经发育障碍患病率的首次报告。尽管研究样本较小,但与文献报道的患病率相比,未发现风险增加。