Department of Anesthesiology and Critical Care Medicine, Caen University Hospital, Avenue de la Côte de Nacre, Caen 14033, France; Normandie Université, UNICAEN, INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institute Blood and Brain @ Caen-Normandie (BB@C), GIP Cyceron, Caen 14000, France.
Université de Paris, LaPsyDÉ, CNRS, F-75005 Paris, France; Institut Universitaire de France (IUF), Paris, France.
Neuroscience. 2021 May 1;461:172-179. doi: 10.1016/j.neuroscience.2021.02.029. Epub 2021 Mar 4.
In 2017, the Food and Drug Administration published a safety recommendation to limit the exposure to general anesthesia as much as possible below the age of three. Indeed, several preclinical and clinical studies have questioned the possible toxicity of general anesthesia on the developing brain. Since then, recent clinical studies tried to mitigate this alarming issue. What is true, what is false? Contrary to some perceptions, the debate is not over yet. Only stronger translational research will allow scientists to provide concrete answers to this public health issue. In this review, we will provide and discuss the more recent data in this field, including the point of view of preclinical researchers, neuropsychologists and pediatric anesthesiologists. Through translational research, preclinical researchers have more than ever a role to play to better understand and identify long-term effects of general anesthesia for pediatric surgery on brain development in order to minimize it.
2017 年,美国食品和药物管理局发布了一项安全建议,要求尽可能减少三岁以下儿童接受全身麻醉的次数。事实上,一些临床前和临床研究质疑全身麻醉对发育中大脑的潜在毒性。此后,最近的临床研究试图缓解这一令人担忧的问题。哪些是真的,哪些是假的?与一些看法相反,这场争论尚未结束。只有更强有力的转化研究才能让科学家们为这一公共卫生问题提供具体答案。在这篇综述中,我们将提供并讨论该领域的最新数据,包括临床前研究人员、神经心理学家和儿科麻醉师的观点。通过转化研究,临床前研究人员比以往任何时候都更有机会发挥作用,以更好地理解和识别小儿外科全身麻醉对大脑发育的长期影响,从而将其最小化。