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Wu Z, Yu W, Song Y, Zhao P. General anaesthesia, the developing brain, and cerebral white matter alterations: a narrative review. Br J Anaesth 2023; 131:1022-1029. [PMID: 37833128 DOI: 10.1016/j.bja.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 10/15/2023] Open
Abstract
The potential neurotoxic impact of anaesthetic agents has been the subject of sustained debate and continuing research. White matter, which comprises more than half of the brain volume and largely consists of myelinated axonal bundles, is critical for communication between diverse brain regions and for supporting neurobehavioural function. Evidence points to a correlation between exposure to anaesthesia and white matter alterations, which might underpin the ensuing cognitive and behavioural abnormalities. This review summarises the neuropathological and neuroimaging findings related to anaesthesia-induced white matter alterations in the developing brain. Future research is required to understand the effects of anaesthesia exposure on white matter development.
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Affiliation(s)
- Ziyi Wu
- Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weiwei Yu
- Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanhong Song
- Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ping Zhao
- Department of Anaesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Ocmen E, Erdost HA, Hanci V. The bibliometric analysis of most cited 100 papers in anesthesia-induced neurotoxicity. Medicine (Baltimore) 2023; 102:e36508. [PMID: 38050226 PMCID: PMC10695551 DOI: 10.1097/md.0000000000036508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023] Open
Abstract
Anesthesia-induced neurotoxicity is a major concern for anesthetists for more than 20 years. Many experimental and clinical studies have been conducted on this topic since late 1990s. However, bibliometric analysis of these papers has not been reported. In this study, we aimed to analyze the 100 most cited articles on anesthesia-induced neurotoxicity. It was planned as cross-sectional study. On January 30, 2023, we searched the "Web of Science (WOS)" database for anesthesia-induced neurotoxicity and most cited 100 papers about this topic were obtained. Data such as authors' names, year of publication, name of the journal, type of paper, and citation numbers were analyzed. The most cited 100 papers were read by the investigators, and the anesthetic, animal type in experimental studies, any protective agent and the method for detecting neurotoxicity used in the studies were also noted. There were 75 articles and 22 reviews in the 100 most cited articles. We found that most of the papers in most cited 100 list were published between 2010 to 1024. Most of the papers (11%) were from Harvard University and almost half of the papers (49%) were published in Anesthesiology. A great number of studies were performed in newborns or early childhood (85.5%) and inhalational anesthetics (54.7%) were the most studied anesthetic type. Most of the most cited 100 papers were published in Q1 journals (P = .012) and the continent of the most journals in this list was America (P = .014). The median total and annual citation numbers of funded papers were statistically significantly higher (P < .001 and P < .001 respectively). Anesthesia-induced neurotoxicity is very important, especially for pediatric anesthetists. This study is the first to conduct a bibliometric analysis of the most cited 100 publications on this field. Although there was a gap in the publications about this topic during COVID-19 pandemic, we believe that there will be many more publications on anesthesia-induced neurotoxicity since the mechanism, outcome and possible protection are still unknown.
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Affiliation(s)
- Elvan Ocmen
- Dokuz Eylul University, Department of Anesthesiology and Reanimation, Balçova/Izmir, Turkey
| | - Hale Aksu Erdost
- Dokuz Eylul University, Department of Anesthesiology and Reanimation, Balçova/Izmir, Turkey
| | - Volkan Hanci
- Dokuz Eylul University, Department of Anesthesiology and Reanimation, Balçova/Izmir, Turkey
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Krishnan DG, Schnitzer MA, Adlesic EC, Bui TG, Trowbridge TA, Schultz JD, Weber C, Harper JL. Proceedings of the Third American Association of Oral and Maxillofacial Surgeons Anesthesia Patient Safety Conference. J Oral Maxillofac Surg 2023; 81:1330-1335. [PMID: 37640236 DOI: 10.1016/j.joms.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
The 3rd Anesthesia Patient Safety Conference of the American Association of Oral and Maxillofacial Surgeons was held at the Daniel M Laskin Institute for Oral and Maxillofacial Surgery Education and Innovation at American Association of Oral and Maxillofacial Surgeons headquarters in Rosemont, Illinois on June 6, 2022. The conference provided a platform to scrutinize collective errors, explore optimal practices, comprehend the concepts and principles of human complacency, assessing the system's capacity to handle deviations from the norm, and contemplate ideas and initiatives to enhance our practice model. These safety conferences are designed to foster collaborative, proactive conversations and understand best practices in safe delivery of anesthetic care to our patients.
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Affiliation(s)
- Deepak G Krishnan
- Consultant to the Committee on Anesthesia, AAOMS, Professor of Surgery, Section Chief, Division of Oral & Maxillofacial Surgery, Department of Surgery, University of Cincinnati, Cincinnati, OH.
| | - Mary A Schnitzer
- Associate Executive Director, American Association of Oral and Maxillofacial Surgeons, Staff Liaison to Committee on Anesthesia, AAOMS, Rosemont, IL
| | - Edward C Adlesic
- Chair, Committee on Anesthesia, AAOMS, Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Dental Anesthesiology, University of Pittsburgh, Pittsburgh, PA
| | - Tuan G Bui
- Oral & Maxillofacial Surgeon, South Calgary Oral Surgery, Member, Committee on Anesthesia, AAOMS, Calgary, Alberta, Canada
| | - Thomas A Trowbridge
- Former Member, Committee on Anesthesia, AAOMS, Oral & Maxillofacial Surgeon, Lowell, MA
| | - Jeffrey D Schultz
- Member, Committee on Anesthesia, AAOMS, Oral & Maxillofacial Surgeon, Newnan, GA
| | - Charles Weber
- Consultant, Committee on Anesthesia, AAOMS, Retired Oral & Maxillofacial Surgeon, Olympia, WA
| | - Jimmie L Harper
- Member, Committee on Anesthesia, AAOMS, Oral & Maxillofacial Surgeon, Volunteer Assistant Professor, Division of Oral & Maxillofacial Surgery, Department of Surgery, University of Cincinnati, Cincinnati, OH
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Ing C, Vutskits L. Unanswered questions of anesthesia neurotoxicity in the developing brain. Curr Opin Anaesthesiol 2023; 36:510-515. [PMID: 37552011 PMCID: PMC10939468 DOI: 10.1097/aco.0000000000001295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
PURPOSE OF REVIEW This article reviews recent advances and controversies of developmental anesthesia neurotoxicity research with a special focus on the unanswered questions in the field both from clinical and preclinical perspectives. RECENT FINDINGS Observational cohort studies of prenatal and early childhood exposure to anesthesia have reported mixed evidence of an association with impaired neurodevelopment. Meta-analyses of currently available studies of early childhood exposure to anesthesia suggest that, while limited to no change in general intelligence can be detected, more subtle deficits in specific neurodevelopmental domains including behavior and executive function may be seen. Several studies have evaluated intraoperative blood pressure values and neurocognitive outcomes and have not found an association. Although many animal studies have been performed, taking into consideration other peri-operative exposures such as pain and inflammation may help with translation of results from animal models to humans. SUMMARY Advances have been made in the field of developmental anesthetic neurotoxicity over the past few years, including the recognition that anesthetic exposure is associated with deficits in certain cognitive domains but not others. Although the most important question of whether anesthetic agents actually cause long-term neurodevelopmental effects in children has still not been answered, results from recent studies will guide further studies necessary to inform clinical decision-making in children.
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Affiliation(s)
- Caleb Ing
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons
- Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
| | - Laszlo Vutskits
- Department of Anesthesiology, Pharmacology, Intensive Care, and Emergency Medicine, University Hospitals of Geneva
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
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McCann ME, Soriano SG. Comparer Pommes et Oranges: Perils of Translating Rodent Studies to Human Outcomes. Anesth Analg 2023; 136:238-239. [PMID: 36638507 DOI: 10.1213/ane.0000000000006329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Mary Ellen McCann
- From the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
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