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
1. Verfasser: Andropoulos, Dean B.
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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.
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source Karger Journal Archive Collection; MEDLINE; Karger Journals; Alma/SFX Local Collection
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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