Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, Hubei, China.
Biomed Res Int. 2020 Jan 7;2020:7380172. doi: 10.1155/2020/7380172. eCollection 2020.
General anesthetic (GA) is used clinically to millions of young children each year to facilitate surgical procedures, relieve perioperative stress, and provide analgesia and amnesia. During recent years, there is a growing concern regarding a causal association between early life GA exposure and subsequently long-term neurocognitive abnormalities. To address the increasing concern, mounting preclinical studies and clinical trials have been undergoing. Until now, nearly all of the preclinical findings show that neonatal exposure to GA causally leads to acute neural cell injury and delayed cognitive impairment. Unexpectedly, several influential clinical findings suggest that early life GA exposure, especially brief and single exposure, does not cause adverse neurodevelopmental outcome, which is not fully in line with the experimental findings and data from several previous cohort trials. As the clinical data have been critically discussed in previous reviews, in the present review, we try to analyze the potential factors of the experimental studies that may overestimate the adverse effect of GA on the developing brain. Meanwhile, we briefly summarized the advance in experimental research. Generally, our purpose is to provide some useful suggestions for forthcoming preclinical studies and strengthen the powerfulness of preclinical data.
全身麻醉（GA）在临床上每年用于数百万名幼儿，以促进手术顺利进行，减轻围手术期压力，并提供镇痛和遗忘作用。近年来，人们越来越关注幼儿期接触 GA 与随后的长期神经认知异常之间是否存在因果关系。为了解决这一日益增长的担忧，大量的临床前研究和临床试验正在进行。到目前为止，几乎所有的临床前研究结果都表明，新生儿接触 GA 会导致急性神经细胞损伤和延迟的认知障碍。出乎意料的是，一些有影响力的临床研究结果表明，幼儿期接触 GA，特别是短暂和单次接触，不会导致不良的神经发育结局，这与实验结果和之前的几项队列试验数据并不完全一致。由于之前的综述已经对临床数据进行了批判性讨论，在本综述中，我们试图分析可能高估 GA 对发育中大脑的不良影响的实验研究中的潜在因素。同时，我们简要总结了实验研究的进展。总的来说，我们的目的是为即将进行的临床前研究提供一些有用的建议，并加强临床前数据的说服力。
