Faculty Advisor(s)

John Hanlon

Document Type

Capstone

Publication Date

6-2017

Rights

© 2017 Nicole Hachey

Abstract

Each year, thousands of neonates receive anesthesia and/or sedation for various surgical procedures. With advancements in neonatal care and surgical techniques, the number of infants receiving anesthesia globally will continue to increase. A relatively large and growing body of literature suggests that exposure to general anesthetics can be detrimental to the developing brain. Based upon various animal studies, it is thought that exposure of the immature brain to anesthetic agents may result in apoptosis, neurodegeneration and ultimately long-term cognitive deficiencies (Walters & Paule, 2016). This information presents a dilemma for practitioners when caring for a neonate requiring a surgical procedure, knowing that exposure to the very agents that will alleviate pain, provide adequate sedation and maintain anesthesia, may also result in adverse neurological outcomes. Further compounding this issue, there is currently no known safe alternatives for children undergoing surgery. Although various literature exists suggesting that general anesthesia (GA) has negative effects on neurodevelopment (ND) outcomes, it is unclear as to what extent. It is also unclear as to what other treatments or health related factors during the neonatal period may contribute to long-term outcomes. The following literature review will provide an examination of various retrospective cohort studies as well as one recent randomized controlled trial, all of which sought to determine the association between exposure to GA during the neonatal or early childhood period with ND outcomes. Variations between the reviewed studies include, type of surgical procedure, age and method of ND assessment, and duration of GA. The goal of this review is to provide a description of what is currently known about the effects of GA on the developing brain and what further research is required.

Comments

Master's capstone

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