Abstract:
PURPOSE OF REVIEW:The purpose of this review is to summarize the current evidence regarding the impact of the exposure to anesthetic and sedative agents on neurodevelopment during the period of rapid brain growth in the first 3 years of life. Though much of the definitive data demonstrating anesthesia-induced neurotoxicity has come from studies in young animals, the focus of this review is on emerging human data. RECENT FINDINGS:In 2016, the first prospective trials investigating the neurodevelopmental impact of early anesthetic exposure (GAS and PANDA studies) were published, both showing no significant impact on IQ from a single brief anesthetic. More recent population cohort analyses have shown varying, but minimal, impacts from early anesthetic exposure on academic performance and IQ, much smaller than that of maternal education and other environmental factors. Animal and human data document that post-anesthetic neurotoxicity is a genuine phenomenon, but its long-term clinical significance is uncertain. Most experts would agree that a single, brief anesthetic likely has no significant impact on neurodevelopment, but it is yet to be determined whether longer exposures or multiple anesthetics are associated with subsequent learning issues. Future research is aimed at determining the mechanisms of neuronal injury from exposure to anesthetic and sedative agents, adjunctive medications that may prevent or ameliorate this injury, and therapeutic approaches such as early intervention that can enhance recovery. While these studies are underway, it is recommended that exposure to anesthetic and sedative agents be minimized in young children and consideration be given to alternative methods of immobilization for nonpainful procedures such as radiologic imaging.
journal_name
Curr Treat Options Neuroljournal_title
Current treatment options in neurologyauthors
Vinson AE,Houck CSdoi
10.1007/s11940-018-0536-zsubject
Has Abstractpub_date
2018-10-13 00:00:00pages
51issue
12eissn
1092-8480issn
1534-3138pii
10.1007/s11940-018-0536-zjournal_volume
20pub_type
杂志文章,评审abstract::The treatments for obstructive sleep apnea (OSA) described in this paper represent the latest information and data. Nasal continuous positive airway pressure, initially described in 1981, remains the cornerstone of therapy. Advances in mask interfaces, the use of humidification, the downloading of usage information, t...
journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
pub_type: 杂志文章
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journal_title:Current treatment options in neurology
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journal_title:Current treatment options in neurology
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