Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA; Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
Best Pract Res Clin Anaesthesiol. 2023 Mar;37(1):28-39. doi: 10.1016/j.bpa.2023.03.004. Epub 2023 Mar 27.
Advances in the field of pediatric anesthesiology have enabled the performance of complex and life-saving procedures with minimal patient discomfort. However, preclinical studies over the past two decades have been reporting substantial neurotoxic potential of general anesthetics in young brain, thus challenging the safety of these agents in pediatric anesthesiology practice. Notwithstanding the overwhelming preclinical evidence, the translatability of these findings has proven inconsistent in human observational studies. The significant degree of anxiety and apprehension surrounding the uncertainty of long-term developmental outcomes following early exposure to anesthesia has prompted numerous studies around the world to investigate the putative mechanisms and translatability of preclinical findings regarding anesthesia-induced developmental neurotoxicity. Guided by the vast preclinical evidence, we aim to highlight relevant human findings presented in the currently available clinical literature.
儿科麻醉学领域的进展使得可以在最小化患者不适的情况下进行复杂且救生的手术。然而,过去二十年的临床前研究报告称,全身麻醉在年轻大脑中具有实质性的神经毒性潜力,从而对这些药物在儿科麻醉学实践中的安全性提出了挑战。尽管有压倒性的临床前证据,但这些发现的转化在人类观察性研究中证明并不一致。由于早期接触麻醉后长期发育结果的不确定性而引起的极大焦虑和担忧,促使世界各地的许多研究调查了关于麻醉诱导的发育神经毒性的临床前发现的推测机制和可转化性。在大量临床前证据的指导下,我们旨在强调当前临床文献中提出的相关人类研究结果。