Neurocognitive Effects of Fetal Exposure to Anesthesia

Olutoye, Olutoyin A.; Style, Candace C.; Menchaca, Alicia D

doi:10.1016/j.anclin.2021.08.015

Cited by 5 publications

(3 citation statements)

References 85 publications

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“…Nevertheless, the potential deleterious effects of anesthesia should also be investigated during other periods of brain maturation (such as the first trimester or puberty). For example, the risks of prenatal anesthetic exposure are topics of main concern trending in current research, both in preclinical and clinical settings [ 47 , 48 , 49 ]. Therefore, continuous monitoring is essential, and the study of animal models can help in understanding where to focus efforts.…”

Section: Discussionmentioning

confidence: 99%

Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

Colletti

Bartolomeo

Negrello

et al. 2023

JPM

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The effect of multiple general anesthesia (mGA) procedures administered in early life is a critical theme and has led the Food and Drug Administration (FDA) to issue an alert. This systematic review seeks to explore the potential effects on neurodevelopment of mGA on patients under 4 years. The Medline, Embase and Web of Science databases were searched for publications up to 31 March 2021. The databases were searched for publications regarding “children multiple general anesthesia OR pediatric multiple general anesthesia”. Case reports, animal studies and expert opinions were excluded. Systematic reviews were not included, but they were screened to identify any possible additional information. A total of 3156 studies were identified. After removing the duplicates, screening the remaining records and analyzing the systematic reviews’ bibliography, 10 studies were considered suitable for inclusion. Comprehensively, a total cohort of 264.759 unexposed children and 11.027 exposed children were assessed for neurodevelopmental outcomes. Only one paper did not find any statistically significant difference between exposed and unexposed children in terms of neurodevelopmental alterations. Controlled studies on mGA administered before 4 years of age support that there might be a greater risk of neurodevelopmental delay in children receiving mGA, warranting the need for careful risk/benefit considerations.

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Section: Discussionmentioning

confidence: 99%

Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

Colletti

Bartolomeo

Negrello

et al. 2023

JPM

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“…Furthermore, there is concern for potential adverse neurocognitive development in fetuses exposed to high-dose inhalational agents. 128,129 Maternal laparotomy is associated with morbidity, including prolonged postoperative recovery. Midgestation hysterotomy is performed through the muscular portion of the uterus and is associated with increased risk of uterine dehiscence and rupture for the index pregnancy and all future pregnancies.…”

Section: Prenatal Repair Of Open Spina Bifidamentioning

confidence: 99%

Advances in Fetal Surgical Repair of Open Spina Bifida

Chmait

Monson

Chon

2023

Obstetrics &Amp; Gynecology

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Spina bifida remains a common congenital anomaly of the central nervous system despite national fortification of foods with folic acid, with a prevalence of 2-4 per 10,000 live births. Prenatal screening for the early detection of this condition provides patients with the opportunity to consider various management options during pregnancy. Prenatal repair of open spina bifida, traditionally performed by the open maternal-fetal surgical approach through hysterotomy, has been shown to improve outcomes for the child, including decreased need for cerebrospinal fluid diversion surgery and improved lower neuromotor function. However, the open maternal-fetal surgical approach is associated with relatively increased risk for the patient and the overall pregnancy, as well as future pregnancies. Recent advances in minimally invasive prenatal repair of open spina bifida through fetoscopy have shown similar benefits for the child but relatively improved outcomes for the pregnant patient and future childbearing.

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“…Attention should be paid to the administration of maternal anaesthetics during the pregnancy [106], due to the risks highlighted in 2016 by the Food and Drug Administration, which suggested not to exceed the 3-hour exposure to anaesthetics for children under the age of 3 years [107]. This group potentially includes the foetal population exposed to anaesthetics during maternal anaesthesia.…”

Section: The Neurotoxicity For the Foetusmentioning

confidence: 99%

Foetal pain and anaesthesia during prenatal surgery

Bellieni¹

2022

Clin. Exp. Obstet. Gynecol.

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Objectives: Foetal surgery is a relatively new branch of medicine; the health providers involved are currently wondering what kind of anaesthesia should be provided to the foetuses. In the last few years, new advances have been reported on foetal sensoriality and capability for feeling pain; meanwhile alerts have been issued on the risks of prolonged anaesthesia in the early infancy. Aim of this paper is reviewing the main data on foetal pain, to be aware of which is the time in pregnancy when it is likely to be felt. The secondary aim is to point out which are the anaesthetics and analgesics appropriate for prenatal surgery. Mechanism: A review of the literature published in the last 20 years in the field of fetal sensoriality and fetal sergery has been carried out; the most pertinent papers have been retrieved, and their conclusions are here summarized and analysed. Findings in brief: Pain can be felt by the human fetus in the second half of pregnancy: data of physiological and behavioural studies show it with increasing evidence, as long as the gestational age increases. With regard to the best anaesthesia in this case, it seems that the mere anaesthetics given to the mother, though apparently sufficient during laparoscopic surgery, are not sufficient to anesthetize the foetus during open surgery; here some references are given for the best and safest foetal direct analgesic treatment. Conclusions: Surgeons should approach carefully fetal surgery, according with the latest findings in this field.

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Neurocognitive Effects of Fetal Exposure to Anesthesia

Cited by 5 publications

References 85 publications

Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

Advances in Fetal Surgical Repair of Open Spina Bifida

Foetal pain and anaesthesia during prenatal surgery

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