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PLoS One:麻醉或可影响机体的神经和认知响

2017-06-14 MedSci MedSci原创

一系列的动物实验表明,婴儿早期大脑接受全麻但未进行手术,可能会对神经和认知发展产生不良影响。调节这一过程的机制很复杂,包括大脑细胞死亡的增加。 在人类,将有害认知发展和婴儿麻醉暴露联系在一起的尝试得到一个模糊的结果。一个可能影响人类研究诠释的警告是婴儿全麻下手术,增加了手术本身可能会导致不良认知发展的可能性。 本研究使用仔猪,研究了在新生大脑,小手术是否会增加细胞死亡,破坏神经

一系列的动物实验表明,婴儿早期大脑仅接受全麻,但并未进行手术,可能会对神经和认知发展产生不良影响。参与调节这一过程的机制十分复杂,已知的是麻醉可增加大脑细胞死亡的数目由此影响机体的神经和认知。


既往研究人员曾试图在认知损害与婴儿时期暴露于麻醉找到某些关联,但并未得到一个明确的结果。但是研究人员提醒道,婴儿全麻下手术,或可因麻醉而加重机体的认知损害。

本研究使用仔猪,探究了新生大脑中,手术是否会增加细胞死亡、破坏神经发展以及认知。将雄性新生仔猪随机分配为两组,一组给予2%异氟醚麻醉6h,另一组接受相同的麻醉再加15min腹股沟疝修补术。

结果发现,和单独麻醉组相比,手术组大脑的八个区域细胞死亡数目显著增加。分析数据,研究人员还发现在大脑扣带皮层,手术导致181个基因转录表达显著改变,这些改变的通路分析显示手术可影响凝血酶、醛固酮、轴突导向、B细胞、ERK-5、eNOS和GABAA信号传导通路。

总而言之,该研究结果提出一些新的机制,手术可能独立或与麻醉协同影响神经和认知发展。

原始出处:

Kevin D. Broad, Go Kawano, et al., Surgery increases cell death and induces changes in gene expression compared with anesthesia alone in the developing piglet brain.  PLoS One. 2017; 12(3): e0173413. Published online 2017 Mar 29. doi:  10.1371/journal.pone.0173413.

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    2017-06-26 semrour

    真的不希望对认知有影响,不然以后谁敢接受麻醉了

    0

  3. 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    2017-06-16 1e10c84am36(暂无匿称)

    好文章,值得拜读,受益

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 zhangqingzui

    好好学习,感谢分享

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 1e10c84am36(暂无匿称)

    好文章,值得拜读,受益

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 o9887

    学习了

    0

  7. 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createdName=微笑人参, createdTime=Wed Jun 14 23:05:22 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210612, encodeId=5f3521061201, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2cQVB0w6wKXcuEC4Enl0NTBvgHc6yoUM80A3TDia90Fo2MPicibnfm59eh7A0WoicrZXI2hde9ctxKPrlXhzNdL6oZ/0, createdBy=27371624227, createdName=zhangqingzui, createdTime=Wed Jun 14 10:04:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210603, encodeId=5a182106036e, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 流逝的青春

    学习了!谢谢分享!

    0

  8. 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createdTime=Thu Jun 15 06:05:54 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210860, encodeId=7f41210860af, content=学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/08/24/26b17bef207f5a16bb76644d2b22859e.jpg, createdBy=799d1992408, createdName=流逝的青春, createdTime=Thu Jun 15 05:59:21 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210825, encodeId=be5c210825d3, content=会影响,认知, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220317/1c3b2db4747d42e88e5018b394979434/be0fcebf07344e9ab886c37c502e2f29.jpg, createdBy=6bb22051299, createdName=微笑人参, createdTime=Wed Jun 14 23:05:22 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210612, encodeId=5f3521061201, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2cQVB0w6wKXcuEC4Enl0NTBvgHc6yoUM80A3TDia90Fo2MPicibnfm59eh7A0WoicrZXI2hde9ctxKPrlXhzNdL6oZ/0, createdBy=27371624227, createdName=zhangqingzui, createdTime=Wed Jun 14 10:04:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210603, encodeId=5a182106036e, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 微笑人参

    会影响,认知

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 zhangqingzui

    好好学习,感谢分享

    0

  10. 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createdName=微笑人参, createdTime=Wed Jun 14 23:05:22 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210612, encodeId=5f3521061201, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2cQVB0w6wKXcuEC4Enl0NTBvgHc6yoUM80A3TDia90Fo2MPicibnfm59eh7A0WoicrZXI2hde9ctxKPrlXhzNdL6oZ/0, createdBy=27371624227, createdName=zhangqingzui, createdTime=Wed Jun 14 10:04:03 CST 2017, time=2017-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210603, encodeId=5a182106036e, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 14 09:42:27 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 明月清辉

    谢谢分享,学习了

    0

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麻醉时发生的速发型过敏反应分为变应性过敏(皮肤试验和肥大细胞类胰蛋白酶阳性)和非变应性的(皮肤试验和肥大细胞类胰蛋白酶阴性)。半胱氨酰白三烯(CysLTs)是由肥大细胞及嗜酸性粒细胞合成的强效介质,可诱导支气管收缩,在过敏反应中起到一定的作用。 研究纳入了21名麻醉对照组和34名麻醉期间发生过敏反应的患者(24名为变应性,10名为非变应性),手机血浆样本,使用竞争性免疫分析血浆中的CysLT

Medicine:术前催眠会话对双异丙酚需求量的影响

自动化管理丙泊酚可用于客观评估催眠疗法的非药物麻醉作用。本研究旨在评估催眠会话对麻醉诱导中丙泊酚的用量的影响。 采用随机、常规护理控制、单中心、患者单盲试验研究设计,在法国三级护理中心进行,时间为2012年11月至2013年12月,纳入了全身麻醉下接受外科手术的成年患者。 术前使用计算机生成的随机列表将患者随机分组,分为术前对话催眠会话组或常规护理组。由专业治疗师在安静的环境中进行会话

Sci Rep:改进的俯卧位导管可降低气管导管移位的发生率

气管导管移位或脱位是一种严重的并发症,通常发生在需要俯卧位通气的患者中。本研究假设与传统导管(TT)相比,俯卧位导管(PPT)将减少在成人俯卧操作时的气管内导管移位的发生率。 研究共招募了80名需要接受神经外科或脊柱手术的成人患者。最终纳入60名进行研究,等比随机分为俯卧位通气气管插管组(PPT组)和常规气管插管组(TT组)。主要观察指标为术中气管导管移位的发生率,次要结果为麻醉后监护病房(

Saudi J Anaesth:上颌牙麻醉使用4%阿替卡还是2%甲哌卡因?

本研究旨在探究上颌牙齿拔除时4%阿替卡因与2%甲哌卡因麻醉的起效速度与注射不适情况。 研究共纳入了90名患者,分别接受4%阿替卡因(45名)和2%甲哌卡因(45名)麻醉。麻药注射后使用探针每隔15s客观评价软硬组织的麻木效果。此外,注射的不适感则使用标准的100 mm视觉模拟评分(无疼痛0mm,难以忍受的疼痛100 mm)评估记录。 结果发现,两组患者颊侧浸润麻醉后牙齿和腭侧粘膜麻木感

Lancet Respir Med:重视儿科麻醉危重事件(APRICOT)的发生!

在欧洲,对儿童进行全身麻醉时严重事件的发生率知之甚少。我们的目标是确定儿童进行麻醉时危重事件的发生率,性质和结果,以及相关的潜在危险因素。APRICOT研究是一项前瞻性观察性多中心队列研究,研究对象是由于诊断或外科手术而接受择期或紧急麻醉的儿童,年龄为0-15岁。纳入了欧洲33个国家有261个参与中心。主要终点是围手术期危重事件的发生,需要立即干预。一个危重事件定义为呼吸、心脏、过敏或神经系统的并

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