Effect of Anesthesia on the Developing Brain: Infant and Fetus
The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young ch...
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Veröffentlicht in: | Fetal diagnosis and therapy 2018-01, Vol.43 (1), p.1-11 |
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description | The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures. Because of the significant growth of fetal interventions requiring sedation and analgesia for the fetus, or because of maternal anesthetic effects, this concern about anesthetic neurotoxicity is relevant for the fetus. The potential for anesthetic neurotoxicity is the most important clinical and research problem in the field of pediatric anesthesiology. This review will first briefly summarize the rapid brain growth and development in the fetus and neonate. Next, animal model data of anesthetic neurotoxicity in the fetus and neonate will be presented, followed by a review of recent human clinical anesthetic neurotoxicity trials. Finally, the rationale for studying dexmedetomidine as a potential neuroprotectant agent in anesthetic neurotoxicity will be reviewed along with study design for two human clinical trials involving dexmedetomidine. |
doi_str_mv | 10.1159/000475928 |
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This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures. Because of the significant growth of fetal interventions requiring sedation and analgesia for the fetus, or because of maternal anesthetic effects, this concern about anesthetic neurotoxicity is relevant for the fetus. The potential for anesthetic neurotoxicity is the most important clinical and research problem in the field of pediatric anesthesiology. This review will first briefly summarize the rapid brain growth and development in the fetus and neonate. Next, animal model data of anesthetic neurotoxicity in the fetus and neonate will be presented, followed by a review of recent human clinical anesthetic neurotoxicity trials. 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Karger AG</publisher><subject>Age Factors ; Analgesia ; Anesthesia ; Anesthesia - adverse effects ; Anesthetic gases ; Anesthetics ; Anesthetics - adverse effects ; Animals ; Apoptosis - drug effects ; Behavior, Animal - drug effects ; Brain ; Brain - drug effects ; Brain - growth & development ; Brain - pathology ; Brain research ; Child ; Child Behavior - drug effects ; Child Development - drug effects ; Child, Preschool ; Clinical trials ; Dexmedetomidine ; Dexmedetomidine - therapeutic use ; Disease Models, Animal ; Gestational Age ; Humans ; Infant ; Infant Behavior - drug effects ; Isoflurane ; Medical research ; Neurogenesis - drug effects ; Neurons - drug effects ; Neurons - pathology ; Neuroprotective Agents - therapeutic use ; Neurotoxicity Syndromes - etiology ; Neurotoxicity Syndromes - physiopathology ; Neurotoxicity Syndromes - prevention & control ; Neurotoxicity Syndromes - psychology ; Newborn infants ; Review ; Sevoflurane</subject><ispartof>Fetal diagnosis and therapy, 2018-01, Vol.43 (1), p.1-11</ispartof><rights>2017 S. Karger AG, Basel</rights><rights>2017 S. Karger AG, Basel.</rights><rights>COPYRIGHT 2018 S. Karger AG</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-aff48054255876c7c1333ffddb0c3ff0a4f87c58a4ff8ea7e35458b1d98f2eb83</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,2422,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28586779$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andropoulos, Dean B.</creatorcontrib><title>Effect of Anesthesia on the Developing Brain: Infant and Fetus</title><title>Fetal diagnosis and therapy</title><addtitle>Fetal Diagn Ther</addtitle><description>The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures. Because of the significant growth of fetal interventions requiring sedation and analgesia for the fetus, or because of maternal anesthetic effects, this concern about anesthetic neurotoxicity is relevant for the fetus. The potential for anesthetic neurotoxicity is the most important clinical and research problem in the field of pediatric anesthesiology. This review will first briefly summarize the rapid brain growth and development in the fetus and neonate. Next, animal model data of anesthetic neurotoxicity in the fetus and neonate will be presented, followed by a review of recent human clinical anesthetic neurotoxicity trials. Finally, the rationale for studying dexmedetomidine as a potential neuroprotectant agent in anesthetic neurotoxicity will be reviewed along with study design for two human clinical trials involving dexmedetomidine.</description><subject>Age Factors</subject><subject>Analgesia</subject><subject>Anesthesia</subject><subject>Anesthesia - adverse effects</subject><subject>Anesthetic gases</subject><subject>Anesthetics</subject><subject>Anesthetics - adverse effects</subject><subject>Animals</subject><subject>Apoptosis - drug effects</subject><subject>Behavior, Animal - drug effects</subject><subject>Brain</subject><subject>Brain - drug effects</subject><subject>Brain - growth & development</subject><subject>Brain - pathology</subject><subject>Brain research</subject><subject>Child</subject><subject>Child Behavior - drug effects</subject><subject>Child Development - drug effects</subject><subject>Child, Preschool</subject><subject>Clinical trials</subject><subject>Dexmedetomidine</subject><subject>Dexmedetomidine - therapeutic use</subject><subject>Disease Models, Animal</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Behavior - drug effects</subject><subject>Isoflurane</subject><subject>Medical research</subject><subject>Neurogenesis - drug effects</subject><subject>Neurons - drug effects</subject><subject>Neurons - pathology</subject><subject>Neuroprotective Agents - therapeutic use</subject><subject>Neurotoxicity Syndromes - etiology</subject><subject>Neurotoxicity Syndromes - physiopathology</subject><subject>Neurotoxicity Syndromes - prevention & control</subject><subject>Neurotoxicity Syndromes - psychology</subject><subject>Newborn infants</subject><subject>Review</subject><subject>Sevoflurane</subject><issn>1015-3837</issn><issn>1421-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0cFLwzAUBvAgipvTg3eRgCB46Eyapkk9CHNuOhh40XNJ05ct2qWj6QT_eyOdw4Hk8D3C78shD6FzSoaU8uyWEJIInsXyAPVpEtMoy9LkMMyE8ohJJnroxPv3wKRg6THqxZLLVIisj-4nxoBucW3wyIFvl-CtwrXDYcKP8AlVvbZugR8aZd0dnjmjXIuVK_EU2o0_RUdGVR7OtjlAb9PJ6_g5mr88zcajeaQ54W2kjEkk4UnMuRSpFpoyxowpy4LokEQlRgrNZUgjQQlgPOGyoGUmTQyFZAN01b27UBXk1pm6bZReWa_zEZeUxEzyOKjhPyqcElZW1w6MDfd7hes_hSWoql36utq0tnZ-H950UDe19w2YfN3YlWq-ckrynx3kux0Ee9nZ9aZYQbmTv58ewEUHPlSzgGYHtv1vHk-Gvw</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Andropoulos, Dean B.</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20180101</creationdate><title>Effect of Anesthesia on the Developing Brain: Infant and Fetus</title><author>Andropoulos, Dean B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-aff48054255876c7c1333ffddb0c3ff0a4f87c58a4ff8ea7e35458b1d98f2eb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age Factors</topic><topic>Analgesia</topic><topic>Anesthesia</topic><topic>Anesthesia - adverse effects</topic><topic>Anesthetic gases</topic><topic>Anesthetics</topic><topic>Anesthetics - adverse effects</topic><topic>Animals</topic><topic>Apoptosis - drug effects</topic><topic>Behavior, Animal - drug effects</topic><topic>Brain</topic><topic>Brain - drug effects</topic><topic>Brain - growth & development</topic><topic>Brain - pathology</topic><topic>Brain research</topic><topic>Child</topic><topic>Child Behavior - drug effects</topic><topic>Child Development - drug effects</topic><topic>Child, Preschool</topic><topic>Clinical trials</topic><topic>Dexmedetomidine</topic><topic>Dexmedetomidine - therapeutic use</topic><topic>Disease Models, Animal</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Behavior - drug effects</topic><topic>Isoflurane</topic><topic>Medical research</topic><topic>Neurogenesis - drug effects</topic><topic>Neurons - drug effects</topic><topic>Neurons - pathology</topic><topic>Neuroprotective Agents - therapeutic use</topic><topic>Neurotoxicity Syndromes - etiology</topic><topic>Neurotoxicity Syndromes - physiopathology</topic><topic>Neurotoxicity Syndromes - prevention & control</topic><topic>Neurotoxicity Syndromes - psychology</topic><topic>Newborn infants</topic><topic>Review</topic><topic>Sevoflurane</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andropoulos, Dean B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Fetal diagnosis and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andropoulos, Dean B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Anesthesia on the Developing Brain: Infant and Fetus</atitle><jtitle>Fetal diagnosis and therapy</jtitle><addtitle>Fetal Diagn Ther</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>43</volume><issue>1</issue><spage>1</spage><epage>11</epage><pages>1-11</pages><issn>1015-3837</issn><eissn>1421-9964</eissn><abstract>The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures. Because of the significant growth of fetal interventions requiring sedation and analgesia for the fetus, or because of maternal anesthetic effects, this concern about anesthetic neurotoxicity is relevant for the fetus. The potential for anesthetic neurotoxicity is the most important clinical and research problem in the field of pediatric anesthesiology. This review will first briefly summarize the rapid brain growth and development in the fetus and neonate. Next, animal model data of anesthetic neurotoxicity in the fetus and neonate will be presented, followed by a review of recent human clinical anesthetic neurotoxicity trials. 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subjects | Age Factors Analgesia Anesthesia Anesthesia - adverse effects Anesthetic gases Anesthetics Anesthetics - adverse effects Animals Apoptosis - drug effects Behavior, Animal - drug effects Brain Brain - drug effects Brain - growth & development Brain - pathology Brain research Child Child Behavior - drug effects Child Development - drug effects Child, Preschool Clinical trials Dexmedetomidine Dexmedetomidine - therapeutic use Disease Models, Animal Gestational Age Humans Infant Infant Behavior - drug effects Isoflurane Medical research Neurogenesis - drug effects Neurons - drug effects Neurons - pathology Neuroprotective Agents - therapeutic use Neurotoxicity Syndromes - etiology Neurotoxicity Syndromes - physiopathology Neurotoxicity Syndromes - prevention & control Neurotoxicity Syndromes - psychology Newborn infants Review Sevoflurane |
title | Effect of Anesthesia on the Developing Brain: Infant and Fetus |
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