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Neurotoxizität von Allgemeinanästhetika im Kindesalter

Hinterlässt Narkose Spuren beim Früh-, Neugeborenen und Kleinkind?

Neurotoxicity of general anesthetics in childhood

Does anesthesia leave its mark on premature babies, newborns and infants?

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Zusammenfassung

Zahlreiche tierexperimentelle Untersuchungen zeigen, dass Anästhetika im unreifen Gehirn neurotoxisch wirken können, da sie Apoptose induzieren und die Neuro- sowie Synaptogenese beeinflussen. Im Tierexperiment hat dies erhebliche Auswirkungen auf die neurokognitiven Funktionen der Tiere im späteren Leben. Ob diese tierexperimentellen Ergebnisse auf den Menschen übertragen werden können, ist derzeit Gegenstand intensiver Forschung. In mehreren retrospektiven Untersuchungen konnte kein eindeutiger Zusammenhang zwischen einer Anästhesie im Früh-, Neugeborenen- oder Kleinkindalter und dem Auftreten von Lernstörungen oder Verhaltensauffälligkeiten gefunden werden. Zwei prospektive Studien (GAS und PANDA) sollen weiteren Einblick liefern und diese Frage möglichst klären. Wegen der großen Relevanz des Themas und um für die Problematik im Umgang mit den Eltern mehr Klarheit zu schaffen, haben der Wissenschaftliche Arbeitskreis für Kinderanästhesie und der Wissenschaftliche Arbeitskreis für Neuroanästhesie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) auf der Grundlage der derzeitigen Datenlage eine Stellungnahme verfasst ().

Abstract

Many animal experiments have shown that anesthetics can have a neurotoxic effect on immature brains because they induce apoptosis and influence neurogenesis and synaptogenesis. In animal experiments this has substantial implications for the neurocognitive functions of animals in later life. Whether these results of animal experiments can be transferred to humans is currently the subject of intensive research. In several retrospective studies no clear association between anesthesia in premature babies, newborns or infants and the occurrence of learning disorders or behavioral problems could be found. The prospective studies GAS and PANDA are designed to obtain a deeper insight and if possible to clarify this problem. Because of the high relevance of this topic and in order to achieve more clarity for this problem when dealing with parents, the scientific working group for neuroanesthesia and pediatric anesthesia of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) has formulated a position document on the basis of currently available data.

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Die korrespondierende Autorin weist für sich und ihre Koautoren auf folgende Beziehungen hin: K.E. hält Vorträge für Abbott und einmalige Teilnahme am Advisory Board von Fresenius.

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  1. Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Deutschland

    B. Sinner

  2. Abteilung für Anästhesie und Intensivmedizin, Cnopf’sche Kinderklinik, Klinik Hallerwiese, Nürnberg, Deutschland

    K. Becke

  3. Klinik für Anaesthesiologie, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz, Deutschland

    K. Engelhard

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Sinner, B., Becke, K. & Engelhard, K. Neurotoxizität von Allgemeinanästhetika im Kindesalter. Anaesthesist 62, 91–100 (2013). https://doi.org/10.1007/s00101-013-2139-0

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