Anesthesia and the Developing Brain: Relevance to the Pediatric Cardiac Surgery

Brain Sciences

Lisa Wise-Faberowski¹  Zoel A. Quinonez² 

[1] Lucile Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, CA 94305, USA;

关键词: neurotoxicity;    seizures;    isoflurane;    sevoflurane;    ketamine;    propofol;    etomidate;    desflurane;    dexmedetomidine;   

DOI  :  10.3390/brainsci4020295

来源: mdpi

【 摘 要 】

Anesthetic neurotoxicity has been a hot topic in anesthesia for the past decade. It is of special interest to pediatric anesthesiologists. A subgroup of children potentially at greater risk for anesthetic neurotoxicity, based on a prolonged anesthetic exposure early in development, are those children receiving anesthesia for surgical repair of congenital heart disease. These children have a known risk of neurologic deficit after cardiopulmonary bypass for surgical repair of congenital heart disease. Yet, the type of anesthesia used has not been considered as a potential etiology for their neurologic deficits. These children not only receive prolonged anesthetic exposure during surgical repair, but also receive repeated anesthetic exposures during a critical period of brain development. Their propensity to abnormal brain development, as a result of congenital heart disease, may modify their risk of anesthetic neurotoxicity. This review article provides an overview of anesthetic neurotoxicity from the perspective of a pediatric cardiac anesthesiologist and provides insight into basic science and clinical investigations as it relates to this unique group of children who have been studied over several decades for their risk of neurologic injury.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.