THE EFFECT OF GENERAL ANESTHETICS ON COGNITIVE FUNCTIONS IN CHILDREN
Abstract
Introduction. Recent work and accumulated knowledge over several decades have shown that general anesthetics are potentially toxic to a child’s developing brain. In many animal studies, it has been found that after exposure to anesthesia, neuroinflammation, apoptosis of neurons occurs at certain stages of brain development, and persistent cognitive impairment subsequently forms. A number of cohort studies are alarming in assessing the intellectual development of children who underwent general anesthesia at the age of 3 years. Several studies have found a link between the use of anesthesia in early childhood and the subsequent development of cognitive impairment, the appearance of learning problems. The purpose of the work is to present the results of a systematic review of publications on the problem of the effect of general anesthesia on the cognitive functions of a child. The search for publications was carried out by analyzing PubMed electronic bibliographic databases. Result. In our study the analysis of preclinical studies, as well as the largest retrospective and prospective clinical studies, is carried out; problems in identifying biomarkers associated with the neurotoxicity of general anesthetics are identified; the role of surgical intervention and changes in homeostasis in the formation of postoperative cognitive dysfunction is considered. Conclusion. At the moment, there is no convincing evidence that a single and short exposure (less than 1 hour) to general anesthesia in early childhood has a causal relationship with a negative effect on the neurocognitive functions of the child. Repeated exposure to anesthetics can lead to deterioration of some of the child’s skills. There is a need to conduct new studies related to the prolonged effect of general anesthesia (more than 1 hour) on the nervous system of children, to identify the dependence of the severity of neurotoxicity on the duration of anesthesia and the choice of anesthetic. There is a need to identify suitable biomarkers associated with the neurotoxicity of general anesthetics. It is necessary to study the role of surgical intervention, the type of operation, and temporary changes in systemic homeostasis in the formation of postoperative cognitive dysfunction in children.
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