麻醉诱导神经毒性的神经保护策略

IF 2.8 3区 医学 Q1 ANESTHESIOLOGY
Dean B. Andropoulos (M.D., M.H.C.M., Anesthesiologist in Chief and Chair, Texas Children's Hospital Department of Anesthesiology, Perioperative and Pain Medicine, Professor of Anesthesiology and Pediatrics, Baylor College of Medicine, Houstson, Texas, U.S.A)
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引用次数: 0

摘要

在过去的20年里,已经发表了数百项关于发展中的中枢神经系统的临床前研究,结论是常见的γ-氨基丁酸和N-甲基-d-天冬氨酸结合麻醉剂会导致神经细胞凋亡和其他形式的神经退行性变。一些临床研究,包括前瞻性和双向设计的对照试验,表明在年轻时(通常不到3-4年)暴露于麻醉和手术(单次或多次)与后来的行为和神经发育问题之间存在关联。考虑神经保护策略很重要,因为科学家和临床医生都在思考如何潜在地改善世界各地每年接受手术和麻醉的数百万婴儿和儿童的神经发育结果。这篇综述将讨论合理的神经保护策略,包括替代麻醉剂、神经保护性非麻醉药物和生理神经保护。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neuroprotective strategies in anesthesia-induced neurotoxicity

Over the past 20 years, hundreds of preclinical studies of the developing central nervous system have been published concluding that the common γ-aminobutryic acid and N-methyl-d-aspartate binding anesthetic agents cause neuroapoptosis and other forms of neurodegeneration. Some clinical studies, including controlled trials, both prospective and ambidirectional in design, indicate an association between any exposure (single or multiple) to anesthesia and surgery at a young age, generally less than 3–4 years, and later behavioral and neurodevelopmental problems. A consideration of neuroprotective strategies is important, as scientists and clinicians alike ponder methods to potentially improve the neurodevelopmental outcomes of the millions of infants and children who undergo surgery and anesthesia annually around the world. This review will address plausible neuroprotective strategies and include alternative anesthetics, neuroprotective nonanesthetic drugs, and physiologic neuroprotection.

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