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Bedah Anestesi  pada anak-anak terkait dengan efek pada IQ , struktur otak

Date:

June 8, 2015

Source:

Cincinnati Children's Hospital Medical Center

Summary:

Anak-anak yang menerima anestesi umum untuk operasi sebelum usia 4 telah berkurangnya  pemahaman bahasa , IQ rendah dan penurunan kepadatan materi abu-abu di daerah posterior otak mereka , menurut sebuah studi baru . Para penulis studi ini merekomendasikan penelitian tambahan untuk menentukan efek molekul anestesi  yang tepat  pada otak dan kontribusi untuk fungsi otak yang berkurang dan komposisinya .

................... Para peneliti dari Rumah Sakit Anak Medical Center Cincinnati melaporkan temuan mereka dalam jurnal 8 Juni edisi online . Para penulis merekomendasikan penelitian tambahan untuk menentukan efek molekul anestesi yang tepat  pada otak dan kontribusi untuk fungsi otak yang  berkurang dan komposisinya . Para peneliti mengatakan pengetahuan ini bisa memungkinkan untuk mengembangkan strategi mitigasi untuk apa yang penulis gambarkan sebagai dilema potensial untuk kesehatan anak ....more

Surgical
anesthesia in young children linked to effects on IQ, brain structure

Date:

June 8, 2015

Source:

Cincinnati Children's Hospital Medical Center

Summary:

Children who received general anesthesia for surgery before age 4 had
diminished language comprehension, lower IQ and decreased gray matter density
in posterior regions of their brain, according to a new study. The authors of
the study recommend additional studies to determine anesthesia's precise
molecular effects on the brain and contribution to diminished brain function
and composition.

......................

Children who received general anesthesia for surgery before age 4 had
diminished language comprehension, lower IQ and decreased gray matter density
in posterior regions of their brain, according to a new study in the journal Pediatrics.

Researchers from Cincinnati Children's Hospital Medical Center report their
findings in the journal's June 8 online edition. The authors recommend
additional studies to determine anesthesia's precise molecular effects on the
brain and contribution to diminished brain function and composition.
Researchers say this knowledge could make it possible to develop mitigating
strategies for what the authors describe as a potential dilemma for child
health.

"The ultimate goal of our laboratory and clinical research is to
improve safety and outcomes in young children who have no choice but to undergo
surgery with anesthesia to treat their serious health concerns," said
Andreas Loepke, MD, PhD, FAAP, lead study author and an anesthesiologist in the
Department of Anesthesiology at Cincinnati Children's. "We also have to
better understand to what extent anesthetics and other factors contribute to
learning abnormalities in children before making drastic changes to our current
practice, which by all measures has become very safe."

Loepke and his research colleagues have published previous studies showing
widespread cell death, permanent deletion of neurons and neurocognitive
impairment in laboratory rats and mice after exposure to general anesthesia.
Those studies have raised concerns about similar effects in young children
during a particularly sensitive neurodevelopmental period in early life, which
researchers say could interfere with the refinement of neuronal networks and
lead to long-term functional abnormalities.

For their current retrospective study, the authors compared the scores of
53 healthy participants of a language development study (ages 5 to 18 years
with no history of surgery) with the scores of 53 children in the same age
range who had undergone surgery before the age of 4.

The authors stress that average test scores for all 106 children in the
study were within population norms, regardless of surgical history. Still,
compared with children who had not undergone surgery, children exposed to
anesthesia scored significantly lower in listening comprehension and
performance IQ. Researchers also report that decreased language and IQ scores
were associated with lower gray matter density in the occipital cortex and cerebellum
of the brain.

Researchers, who used extensive analysis of surgical and other medical
records, said the children were matched for age, gender, handedness and
socioeconomic status -- all confounding factors of cognition and brain
structure. The authors also factored into their calculations the types of
surgeries and length of exposure to anesthetics. The anesthetics used during
the surgeries included common agents such as sevoflurane, isoflurane or
halothane (used alone or in combination) and nitrous oxide.

Children included in the study did not have a history of neurologic or
psychological illness, head trauma or any other associated conditions.
Neurocognitive assessments included the Oral and Written Language Scales and
the Wechsler Intelligence Scale. Brain structural comparisons were conducted by
MRI scans.

Estimated Social Cost

Extending their study a step beyond the medical data, the research team
also considered the potential societal impact of their findings. Earlier
research from 2008 had estimated the loss of 1 IQ point to decrease a person's
lifetime earnings potential by $18,000. Factoring in the potential loss of 5 or
6 IQ points found in their current study, the researchers report that, based on
the estimated 6 million children who undergo surgery in the United States each
year the lifetime potential earnings loss could total $540 billion.

Emphasis on Safety

Although data in the current study highlight the need to look for improved
methods of administering anesthesia, Loepke and his colleagues emphasize that
current methods are very safe. Loepke advises parents who are concerned to
discuss with their pediatrician and surgeon the risks of a surgical procedure
-- and the potential risk of anesthetic exposure -- versus the risks of not
having a surgery.

"It is important to note that no surgeries are truly elective in young
children," Loepke said. "Many surgical procedures early in life treat
life-threatening conditions, avert serious health complications, or improve
quality of life. These cannot be easily postponed or avoided."

Loepke also stressed that researchers at Cincinnati Children's are actively
looking for alternative anesthetic techniques in their ongoing laboratory
studies. Drugs are being tested that show potential for lessening the harmful
effects of anesthetics in laboratory rats and mice, and this research is
ongoing. Additionally, the medical center is participating in an international
clinical trial to test an alternative anesthetic regimen in young children
undergoing urological procedures.







Story Source:

The above post is reprinted from materials provided byCincinnati Children's Hospital Medical Center. Note:
Materials may be edited for content and length.







Journal Reference:

1.   
Barynia Backeljauw, Scott K. Holland, Mekibib Altaye, and Andreas W.
Loepke. Cognition and Brain Structure Following Early Childhood Surgery
With Anesthesia.Pediatrics, June 2015 DOI: 10.1542/peds.2014-3526

http://www.sciencedaily.com/releases/2015/06/150608083103.htm

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