在生命早期经历麻醉和手术会损害认知和行为发展
Xuqin Jia1, Siyou Tan1, Yinying Qin1
1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Frontiers in neuroscience
|August 8, 2024
概括
早期麻醉和手术可以影响儿童的认知和行为发展,暴露频率和年龄等因素起作用. 特定的麻醉剂也可能影响结果,需要仔细的临床考虑.
科学领域:
- 儿科神经发育研究的研究.
- 麻醉学和手术的结果.
- 儿童心理学和行为学
背景情况:
- 早期暴露于麻醉和手术对儿童神经认知和行为发展的长期影响尚未完全理解.
- 现有的研究对手术程序,麻醉剂和幼儿发育轨迹之间的复杂相互作用提供了有限的洞察力.
研究的目的:
- 研究一般麻醉和早期外科手术对儿童后来的认知和行为发展的影响.
- 确定与麻醉,手术和患者特征相关的特定因素,这些因素可能会影响神经发育结果.
主要方法:
- 经过全身麻醉和手术的0-3岁儿童队列与没有这种暴露的匹配对照组进行了比较.
- 认知能力使用韦克斯勒学前初级智力量表 (WPPSI-IV) 进行评估,行为发展使用盖塞尔发育表 (GSCH) 和儿童行为检查表 (CBCL) 进行评估.
- 统计分析检查了麻醉药物,手术持续时间,暴露次数和人口因素对发育结果的影响.
主要成果:
- 与对照组相比,暴露于麻醉和手术的儿童在工作记忆指数 (WMI) 中表现出显著差异.
- 雷米芬坦尼尔暴露与较低的发育系数 (DQ) 相关,而芬太尼尔暴露与更高 (更差) 的儿童行为检查表 (CBCL) 总分相关.
- 暴露频率增加,暴露年龄较小,体重较低,手术持续时间较长与认知和行为发展方面的挑战有关.
结论:
- 早期暴露于手术和麻醉可能会对认知和行为发展产生负面影响,特别是暴露频率较高,年龄较小和体重较低.
- 不同的麻醉剂,包括remifentanil和fentanyl,证明了对认知和行为结果的各种影响.
- 在接受手术的儿科患者使用阿片类止痛药 (如雷米芬坦尼尔和芬太尼尔) 时,建议采取临床谨慎.
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