Format

Send to

Choose Destination
Curr Opin Anaesthesiol. 2018 Jun;31(3):297-301. doi: 10.1097/ACO.0000000000000577.

Long-term neurocognitive outcomes following surgery and anaesthesia in early life.

Author information

1
Department of Anaesthesia & Intensive Care - Paediatric Section, Odense University Hospital.
2
Clinical Institute - Anaesthesiology, University of Southern Denmark, Odense, Denmark.
3
School of Medicine and Dentistry, University of Aberdeen, Royal Aberdeen Children's Hospital, Aberdeen, UK.

Abstract

PURPOSE OF REVIEW:

Repeated controversial and alarming statements of the potential dangers of anaesthetic agents on neurological outcomes in children continue to be issued based primarily on preclinical studies. This review assesses the current evidence of laboratory and clinical data and identifies areas of concerns.

RECENT FINDINGS:

Published animal and laboratory data consistently indicate that prolonged and excessive use of anaesthetic agents can lead to morphological changes and neurocognitive impairment in animals without a clear cut-off age or a superiority of one technique over another. Retrospective human studies and prospective clinical trials indicate that short exposures to anaesthesia and surgery are safe and have no effect on long-term neurological outcomes. Small and consistent continuing improvements in the perioperative period (aggregation of marginal gains) will impact on long-term neurological morbidity in humans.

SUMMARY:

It is biologically plausible that anaesthetic agents may induce structural changes during mammalian brain development and beyond. However, in the absence of alternatives the impact of the choice of anaesthetic drugs on long-term neurocognitive outcomes is almost certainly to be of limited relevance in humans. The underlying disease processes, surgical intervention, and trauma as well as other known perioperative factors more significantly affect these outcomes.

PMID:
29432291
DOI:
10.1097/ACO.0000000000000577
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center