From the Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Departments of Physiology.
Anesth Analg. 2018 Apr;126(4):1393-1396. doi: 10.1213/ANE.0000000000002833.
SmartTots (http://smarttots.org/) represents a public-private partnership between the International Anesthesia Research Society and the US Food and Drug Administration. Over the past 7 years, SmartTots has worked in collaboration with various stakeholders to determine whether anesthetic drugs have detrimental effects on the developing brain. SmartTots has funded clinical and preclinical studies, organized meetings, served as a repository of peer-reviewed information, and facilitated the development of consensus-based statements. Here, we report advances in the field of anesthetic neurotoxicity and provide an update on SmartTots' activities. Clinical studies have provided some reassurance that a brief exposure to anesthetic drugs does not cause overt, persistent cognitive deficits. New recommendations aim to increase the reproducibility and "clinical relevance" of data from studies of laboratory animals. Overall, the field has advanced substantially; however, it remains paramount to definitively resolve whether anesthetic drugs are neurotoxic to the immature brain. The results of SmartTots efforts will either ally unwarranted fears or substantially change pediatric anesthetic practice and prompt studies to identify neuroprotective strategies.
SmartTots（http://smarttots.org/）是国际麻醉研究学会与美国食品和药物管理局之间的公私合作伙伴关系。在过去的 7 年中，SmartTots 一直与各利益相关者合作，以确定麻醉药物是否对发育中的大脑有不良影响。SmartTots 资助了临床前和临床研究，组织了会议，作为同行评审信息的存储库，并促进了基于共识的声明的制定。在这里，我们报告了麻醉神经毒性领域的进展，并提供了 SmartTots 活动的最新情况。临床研究提供了一些保证，即短暂接触麻醉药物不会导致明显的、持续的认知缺陷。新的建议旨在提高实验室动物研究数据的可重复性和“临床相关性”。总的来说，该领域已经取得了实质性的进展；然而，确定麻醉药物是否对未成熟的大脑具有神经毒性仍然至关重要。SmartTots 努力的结果要么消除不必要的担忧，要么极大地改变儿科麻醉实践，并促使研究确定神经保护策略。
