Department of Anesthesiology.
Department of Anesthesiology and Intensive Care, Odense University Hospital.
J Neurosurg Anesthesiol. 2019 Jan;31(1):166-169. doi: 10.1097/ANA.0000000000000543.
Clinical researchers studying the long-term neurocognitive effects of anesthetic and sedative agents on children continue to struggle with identifying a phenotype for anesthetic neurotoxicity, the window of vulnerability, and the toxicity threshold in terms of concentration and duration. The Sixth Biennial Pediatric Anesthesia Neurodevelopment Assessment (PANDA) symposium at Columbia University included a moderated poster presentation session where 4 investigators presented their latest contributions to the landscape of clinical anesthetic neurotoxicity research. A lack of standardization in the design of clinical studies in terms of age at exposure, duration and type of exposure, and outcome measures assessed were highlighted by all the investigators. Suggestions for the future direction of clinical trials included the implementation of more consistent study parameters and the employment of standardized neurocognitive testing and imaging before and after exposure to general anesthesia. Presentations covered a broad range of topics including the valid translation of preclinical studies to human subjects, the quantification of real-world exposures to anesthetic and sedative medications, and possible alternatives to these exposures.
临床研究人员一直在努力研究麻醉和镇静药物对儿童的长期神经认知影响，以确定麻醉神经毒性、易损窗口和毒性阈值的表型，包括浓度和持续时间。哥伦比亚大学第六届儿科麻醉神经发育评估（PANDA）研讨会包括一个经过 moderator 主持的海报展示环节，其中 4 名研究人员展示了他们在临床麻醉神经毒性研究领域的最新贡献。所有研究人员都强调了临床研究在暴露年龄、暴露持续时间和类型以及评估的结果指标方面缺乏标准化的问题。对未来临床试验方向的建议包括实施更一致的研究参数，并在全身麻醉暴露前后采用标准化的神经认知测试和成像。演讲涵盖了广泛的主题，包括将临床前研究有效转化为人体研究、量化现实生活中接触麻醉和镇静药物的情况，以及这些接触的可能替代方法。
