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Clinical Evidence for Any Effect of Anesthesia on the Developing Brain

机译：麻醉对发展大脑的任何影响的临床证据

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摘要

A recent U.S. Food and Drug Administration warning advised that prolonged or repeated exposure to general anesthetics may affect neurodevelopment in children. This warning is based on a wealth of preclinical animal studies and relatively few human studies. The human studies include a variety of different populations with several different outcome measures. Interpreting the results requires consideration of the outcome used, the power of the study, the length of exposure and the efforts to reduce the confounding effects of comorbidity and surgery. Most, but not all, of the large population-based studies find evidence for associations between surgery in early childhood and slightly worse subsequent academic achievement or increased risk for later diagnosis of a behavioral disability. In several studies, the amount of added risk is very small; however, there is some evidence for a greater association with multiple exposures. These results may be consistent with the preclinical data, but the possibility of confounding means the positive associations can only be regarded as weak evidence for causation. Finally, there is strong evidence that brief exposure is not associated with any long term risk in humans.
机译：最近的美国食品和药物管理局警告告知，延长或反复接触全面的麻醉药可能会影响儿童的神经发育。这项警告是基于丰富的临床前动物研究和相对较少的人类研究。人类研究包括各种不同群体，具有几种不同的结果措施。解释结果需要考虑所用的结果，研究的力量，曝光程度和减少合并和手术的混淆效果的努力。大多数但不是全部，大量基于人口的研究都在童年期间的外科和后续学术成果略微更差的情况下找到了证据，或增加了对行为残疾的后期诊断风险。在几项研究中，增加风险的数量非常小;但是，有一些关于与多个曝光更大的关系的证据。这些结果可能与临床前数据一致，但混淆的可能性意味着积极的关联只能被视为因果关系的弱证据。最后，有很强的证据表明，短暂的暴露与人类的任何长期风险都没有相关。

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  • 来源
    《Anesthesiology》 |2018年第4期|共14页
  • 作者

    Davidson Andrew J.; Sun Lena S.;

  • 作者单位

    Royal Childrens Hosp Dept Anesthesia &

    Pain Management Melbourne Vic Australia;

    Columbia Univ Coll Phys &

    Surg CH 4-440 North 622 West 168th St New York NY 10032 USA;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 麻醉学;
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