国际麻醉学与复苏杂志   2014, Issue (5): 4-4
    
全身麻醉药物对小儿发育中大脑的影响
仪修文, 李文献1()
1.复旦大学附属眼耳鼻喉科医院 麻醉科
The effects of general anesthetics on brain development of children
 全文:
摘要:

背景 小儿处于脑的快速发育阶段,其神经系统具有高度的可塑性,任何作用于脑部的药物都有可能影响其神经发育过程,因此小儿临床麻醉用药需格外谨慎。已有很多研究发现全身麻醉药可能对小儿发育中的大脑产生不良影响。 目的 旨在通过对近年来临床及基础研究的归纳来阐明全身麻醉药对小儿发育期大脑的不良影响。 内容 以丙泊酚、氯胺酮、七氟醚、地氟醚为例对全身麻醉药在脑发育中可能产生的毒性作用,相关机制及其预防措施等进行简述。 趋向 总结相关研究的研究结果,尽管作用机制尚不完全明确,有待更多更进一步的研究证实,但其对临床小儿麻醉用药仍有一定的指导意义,并推动了其预防干预措施的研究,为未来临床及基础相关研究提供可能方向。

关键词: 全身麻醉药; 神经发育; 发育期大脑; 神经毒性
Abstract:

Background Children are on the peak stage of mental development, and their nervous system is highly plastic. Any medicine that has effect on the brain could impair the mental development of children. So we should pay more attention to the anesthetics used on children. Many researches have proved that general anesthetics may induce harm to the developing brain. Objective This article aims to reveal the adverse effects of general anesthetics to the developing brain by generalizing recent clinical and basic researches. Content Taking propofol, ketamine, sevoflurane and desflurane as examples, this article will briefly highlight the possible toxic effects of the general anesthetics to mental development, the mechanism and the prevention. Trend This review provides possible directions for future researches and guidance for children anesthetic medication by summarizing the results of relevant studies. Although the details of the mechanisms are not completely clear, further research is needed to explore this aspect, I thought it does provide guidance on the anesthetic medication and push the development of the studies on prevention of this impairment.

Key words: General anesthetics; Development of nerve system; Developing brain; Neurotoxic effect