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嬰兒和新生兒麻醉期間的大腦氧合
在新生兒手術(shù)中，麻醉是否會(huì)引起神經(jīng)發(fā)育問(wèn)題？
This has been studied for quite some time and the latest findings still leave the answer ambiguous. A multicenter study led by Vanessa Olbrecht, M.D., M.B.A aimed to shed some light on this imperative question. Though the study didn’t provide a definite answer, it did add a piece to the lasting research puzzle. Let’s take a look at what was discovered.
Potential risk factors of anesthesia during infancy include exposure to toxic substances that disrupt the function of the nervous system, or neurotoxicity, surgical disease, and injury to the brain through lack of oxygen, or cerebral hypoxia-ischemia. These are all mechanisms that can lead to neurocognitive development issues (1). Olbrecht’s study tested 453 infants less than 6 months old who were undergoing general anesthesia for thirty minutes or more. NIRS or near-infrared spectroscopy through Nonin Medical’s SenSmart X-100 system was used to measure cerebral oxygenation.
The study found that mild and moderate low cerebral saturation occurred frequently, but severe desaturation was uncommon. Additionally, low mean arterial pressure although common was not associated with low cerebral saturation.
Similar, but not directly related to Olbrecht’s research, George M. Hoffman, MD, and chief of anesthesia at the Children’s Hospital of Wisconsin and Medical College of Wisconsin (Milwaukee) led a study looking to elucidate weather anesthesia in infancy is linked to neurological impairment, or overall mortality. They tested the patient’s physical status prior to surgery and took this into account with their findings.
Hoffman’s team discovered a strong correlation between overall physical health and mortality following multiple prolonged procedures. This information suggests that the anesthesia coupled with the underlying physical condition of the patient, including diseases and physical status can be a foundation for developing neurological impairment (2).
As this issue remains highly controversial, it is important to use reliable devices such as the SenSmart X-100 system to track cerebral oxygenation during anesthesia. 這可能有助于降低缺氧的風(fēng)險(xiǎn)，進(jìn)而可能降低神經(jīng)損傷的發(fā)展結(jié)果
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