open access

Vol 46, No 2 (2014 Apr-Jun)
Review articles
Submitted: 2014-05-09
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Do we really know the pharmacodynamics of anaesthetics used in new-borns, infants and children? A review of the experimental and clinical data on neurodegeneration

Alicja Bartkowska-Śniatkowska, Jowita Rosada-Kurasińska, Marzena Zielińska, Agnieszka Bienert
DOI: 10.5603/AIT.2014.0020
·
Anaesthesiol Intensive Ther 2014;46(2):101-108.

open access

Vol 46, No 2 (2014 Apr-Jun)
Review articles
Submitted: 2014-05-09

Abstract

The practices of anaesthesiology and intensive therapy are difficult to imagine without sedation or general anaesthesia, regardless of whether the patient is a new-born, baby, child or adult. The relevant concerns for children are distinct from those for adults, primarily due to the effects of anatomical, physiological and pharmacokinetic-pharmacodynamic (PK/PD) differences, which become increasingly important in the brains of children as they develop. The process of central nervous system maturation in humans lasts for years, but its greatest activity (myelination and dynoptogenesis) occurs during the foetal period and the first two years of life. Many experimental studies have demonstrated that exposure to anaesthetic drugs during this period can induce neurodegenerative changes in the central nervous systems of animals. The extrapolation of these results directly to humans must be performed with great caution, but anaesthesiologists around the world must begin to debate the safety of general anaesthesia in humans. Prospective trials should continue being carried out, and anaesthesia and surgery, delayed if possible among the smallest patients. The simultaneous use of different anaesthetics with the same potential neurotox

Abstract

The practices of anaesthesiology and intensive therapy are difficult to imagine without sedation or general anaesthesia, regardless of whether the patient is a new-born, baby, child or adult. The relevant concerns for children are distinct from those for adults, primarily due to the effects of anatomical, physiological and pharmacokinetic-pharmacodynamic (PK/PD) differences, which become increasingly important in the brains of children as they develop. The process of central nervous system maturation in humans lasts for years, but its greatest activity (myelination and dynoptogenesis) occurs during the foetal period and the first two years of life. Many experimental studies have demonstrated that exposure to anaesthetic drugs during this period can induce neurodegenerative changes in the central nervous systems of animals. The extrapolation of these results directly to humans must be performed with great caution, but anaesthesiologists around the world must begin to debate the safety of general anaesthesia in humans. Prospective trials should continue being carried out, and anaesthesia and surgery, delayed if possible among the smallest patients. The simultaneous use of different anaesthetics with the same potential neurotox

Get Citation

Keywords

nervous system, central, sleep; nervous system, anaesthesia, neurodegeneration

About this article
Title

Do we really know the pharmacodynamics of anaesthetics used in new-borns, infants and children? A review of the experimental and clinical data on neurodegeneration

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 46, No 2 (2014 Apr-Jun)

Pages

101-108

DOI

10.5603/AIT.2014.0020

Bibliographic record

Anaesthesiol Intensive Ther 2014;46(2):101-108.

Keywords

nervous system
central
sleep
nervous system
anaesthesia
neurodegeneration

Authors

Alicja Bartkowska-Śniatkowska
Jowita Rosada-Kurasińska
Marzena Zielińska
Agnieszka Bienert

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