TY - JOUR
T1 - Anesthetic-related neurotoxicity in young children
T2 - An update
AU - Gleich, Stephen
AU - Nemergut, Michael
AU - Flick, Randall
PY - 2013/6
Y1 - 2013/6
N2 - PURPOSE OF REVIEW: This review examines the recent data, animal and human, reporting an association between early anesthetic exposure, neuronal cell death, and adverse neurocognitive and behavioral outcomes. RECENT FINDINGS: Numerous studies have demonstrated that essentially all commonly used anesthetics, when used alone or in combination, enhance neuroapoptosis in developing rodent brains with resultant impairment in learning, memory, and cognition. Recently, these data have been extended to include studies of nonhuman primates also demonstrating neuroapoptosis and long-term cognitive deficits in response to anesthetic exposure. Of additional concern are several retrospective cohort studies of humans that suggest an association between early anesthetic exposure and neurocognitive deficits. Prospective data in humans are lacking and, as such, a causal relationship between anesthetic exposure and developmental outcome remains speculative. SUMMARY: Although the evidence from nonhuman primates and humans is overtly concerning, it lacks clinical verification. There are, at present, no data that would dictate a change in clinical practice in the anesthetic management of infants and children.
AB - PURPOSE OF REVIEW: This review examines the recent data, animal and human, reporting an association between early anesthetic exposure, neuronal cell death, and adverse neurocognitive and behavioral outcomes. RECENT FINDINGS: Numerous studies have demonstrated that essentially all commonly used anesthetics, when used alone or in combination, enhance neuroapoptosis in developing rodent brains with resultant impairment in learning, memory, and cognition. Recently, these data have been extended to include studies of nonhuman primates also demonstrating neuroapoptosis and long-term cognitive deficits in response to anesthetic exposure. Of additional concern are several retrospective cohort studies of humans that suggest an association between early anesthetic exposure and neurocognitive deficits. Prospective data in humans are lacking and, as such, a causal relationship between anesthetic exposure and developmental outcome remains speculative. SUMMARY: Although the evidence from nonhuman primates and humans is overtly concerning, it lacks clinical verification. There are, at present, no data that would dictate a change in clinical practice in the anesthetic management of infants and children.
KW - Anesthetics
KW - Neuroapoptosis
KW - Neurotoxicity
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=84877773139&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877773139&partnerID=8YFLogxK
U2 - 10.1097/ACO.0b013e3283606a37
DO - 10.1097/ACO.0b013e3283606a37
M3 - Review article
C2 - 23511038
AN - SCOPUS:84877773139
SN - 0952-7907
VL - 26
SP - 340
EP - 347
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
IS - 3
ER -