Prognostic study of sevoflurane-based general anesthesia on cognitive function in children

Fan, Qing; Cai, Yirong; Chen, Kaizheng; Li, Wenxian

doi:10.1007/s00540-013-1566-z

Cited by 33 publications

(21 citation statements)

References 26 publications

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“…In contrast to our results and the above-mentioned studies, Kayaalp et al [26] reported that repeated general anesthesia does not seem to disturb the child's psychological health further when proper perioperative management is undertaken, such as the use of proper premedication, effective postoperative pain control, having good rapport with children, and performing the surgery and anesthesia on an outpatient basis, where possible [26]. Fan et al [27] have another opinion that sevoflurane-based general anesthesia does not have significant adverse effects on the attention and other cognitive functions in children between the ages of 4 and 7 years when evaluated at 1 month and 6 months after exposure to general anesthesia. Also, Cans [28] cited that most pediatric general anesthesia studies were observational studies, showing a very mild adverse effect on cognitive functions.…”

Section: Discussioncontrasting

confidence: 76%

Psychiatric sequel of repeated pediatric general anesthesia

Sayed¹,

Bakrey²,

Elsedfy³

2015

Middle East Current Psychiatry

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Middle East Current Psychiatry 2015, 22:164-170 Background Repeated anesthesia and surgery in young children are distressing for children and families, leading to anxiety and psychological disturbances in the children. Preclinical and clinical data suggest a high possibility of neurotoxicity after exposure of young children to general anesthetics, with subsequent behavioral and emotional disturbances. ObjectiveThe aim of this study was to determine the overall psychiatric effect of repeated general anesthesia on the cognitive function, the behavior, and emotions of young 1½-5-year-old children compared with a control group of healthy children attending the vaccination clinic. Patients and methodsThirty-five children who underwent repeated anesthesia were recruited and matched with the same number of healthy children who attended the vaccination clinic as a control group. Both groups were administrated the Child Behavior Checklist 1½-5 years and the Diagnostic and Statistical Manual of Mental Disorders (DSM) oriented scale. Behavior data were collected through a semistructured questionnaire. ResultsThe Child Behavior Checklist score revealed that children with repeated anesthesia were more likely to become anxious or depressed, to have sleep and attention problems, to become aggressive, and to develop internalized and externalized behavioral problems. There were no statistically significant differences between the two groups regarding problems of being emotionally reactive, having somatic complaints or being withdrawn. On the DSM scale, children with repeated anesthesia were more likely to develop affective and anxiety problems and attention-deficit/ hyperactivity problems. There were no statistically significant differences between the two study groups regarding pervasive developmental and oppositional defiant problems. ConclusionYoung pediatric patients undergoing repeated surgical procedures under general anesthesia are more likely to have subsequent behavioral and emotional disturbances. Proper perioperative pain management, psychological counseling, and social support could minimize these untoward consequences.

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Section: Discussioncontrasting

confidence: 76%

Psychiatric sequel of repeated pediatric general anesthesia

Sayed¹,

Bakrey²,

Elsedfy³

2015

Middle East Current Psychiatry

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“…A variety of clinical studies have been performed evaluating the association between anesthesia exposure and long-term cognitive deficits, but the ages of anesthesia exposure have been variable, ranging from exposure in children as early as age 1 to as late as age 7. [12][13][14][15][16][17][18][19][20][21][22] No study to date has specifically evaluated the association between various ages of initial anesthesia exposure and neurodevelopmental deficit.…”

mentioning

confidence: 98%

Neurodevelopmental Outcomes After Initial Childhood Anesthetic Exposure Between Ages 3 and 10 Years

Ing

DiMaggio²,

Whitehouse

et al. 2014

Journal of Neurosurgical Anesthesiology

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“…Retrospective clinical studies were relatively inconclusive, with some, but not all studies, supporting findings of cognitive changes after early childhood exposure to anesthesia (Andropoulos et al, 2014; Bartels et al, 2009; DiMaggio et al, 2009; Fan et al, 2013; Flick et al, 2011; Graham et al, 2016; Ing et al, 2012; Kalkman et al, 2009; O’Leary et al, 2016; Sprung et al, 2009; Sun et al, 2016; Wilder et al, 2009) (See Figure 4, A Timeline - 15 Years of Anesthetic Neurotoxicity). This debate has prompted a few, rigorously designed clinical trials, many of which are just now starting to publish their results.…”

Section: Discussionmentioning

confidence: 99%

A holistic approach to anesthesia-induced neurotoxicity and its implications for future mechanistic studies

Zanghi

Jevtović-Todorović

2017

Neurotoxicology and Teratology

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The year 2016 marked the 15th anniversary since anesthesia-induced developmental neurotoxicity and its resulting cognitive dysfunction were first described. Since that time, multiple scientific studies have supported these original findings and investigated possible mechanisms behind anesthesia-induced neurotoxicity. This paper reviews the existing mechanistic literature on anesthesia-induced neurotoxicity in the context of a holistic approach that emphasizes the importance of both neuronal and non-neuronal cells during early postnatal development. Sections are divided into key stages in early neural development; apoptosis, neurogenesis, migration, differentiation, synaptogenesis, gliogenesis, myelination and blood brain barrier/cerebrovasculature. In addition, the authors combine the established literature in the field of anesthesia-induced neurotoxicity with literature from other related scientific fields to speculate on the potential role of non-neuronal cells and to generate new future hypotheses for understanding anesthetic toxicity and its application to the practice of pediatric anesthesia.

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Prognostic study of sevoflurane-based general anesthesia on cognitive function in children

Cited by 33 publications

References 26 publications

Psychiatric sequel of repeated pediatric general anesthesia

Psychiatric sequel of repeated pediatric general anesthesia

Neurodevelopmental Outcomes After Initial Childhood Anesthetic Exposure Between Ages 3 and 10 Years

A holistic approach to anesthesia-induced neurotoxicity and its implications for future mechanistic studies

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