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Neonatal Pain, Opioid, and Anesthetic Exposure; What Remains in the Human Brain After the Wheels of Time?

Gerbrich E van den Bosch1,2, Dick Tibboel1, Jurgen C de Graaff3

  • 1Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.

Frontiers in Pediatrics
|May 31, 2022
PubMed

Insights

Neonatal exposure to pain, opioids, or anesthetics showed minimal long-term effects in children. However, high opioid exposure was linked to poorer neuropsychological functioning, warranting further study.

Area of Science:

  • Pediatric Medicine
  • Neuroscience
  • Anesthesiology

Background:

  • Neonatal exposure to pain, opioids, and anesthetics may have long-term consequences.
  • Understanding these effects is crucial for child development and long-term health outcomes.

Purpose of the Study:

  • To evaluate potential negative long-term effects of neonatal exposure to pain, opioids, and anesthetics in children and adolescents.
  • To assess neuropsychological functioning, pain sensitivity, and brain structure/function after early-life exposure.

Main Methods:

  • Studied five groups of children with varying neonatal exposure to pain, opioids, or anesthetics, compared to healthy controls.
  • Assessed neuropsychological function, pain thresholds, and performed MRI scans during pain stimulation.
  • Included 94 cases from neonatal cohorts undergoing major surgery, ECMO, preterm birth, or with prenatal opioid exposure.

Main Results:

  • Children with high neonatal opioid exposure (groups 3 and 5) exhibited worse neuropsychological functioning.
  • Group 1 (pain, opioid, anesthetic exposure) showed a thicker left rostral-middle-frontal cortex compared to controls.
  • No significant differences were found in other brain volumes, pain thresholds, or brain activity between groups.

Conclusions:

  • Neonatal exposure to pain, opioids, or anesthetics had no major long-term effects in most children studied.
  • Neuropsychological effects in groups with highest opioid exposure require further investigation.
  • Larger studies are needed to confirm findings and detect subtler differences.
Abstract

Keywords:
anesthesiabrainchildrenhumanneuroimagingopioidspain

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