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Pediatric Radiology
Erschienen in: Pediatric Radiology 1/2018

03.05.2017 | Minisymposium: Minimizing sedation in pediatric MRI

Pediatric anesthesia and neurotoxicity: what the radiologist needs to know

verfasst von: Katherine Barton, Joshua P. Nickerson, Timothy Higgins, Robert K. Williams

Erschienen in: Pediatric Radiology | Ausgabe 1/2018

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Abstract

The use of cross-sectional imaging in the pediatric population continues to rise, particularly the use of MRI. Limiting motion artifact requires cooperative subjects who do not move during imaging, so there has been an increase in the need for pediatric sedation or anesthesia. Over the last decade, concern has increased that exposure to anesthesia might be associated with long-term cognitive deficits. In this review we report current understanding of the effects of anesthesia on the pediatric population, with special focus on long-term developmental and cognitive outcomes, and suggest how radiologists can use new technologies or imaging strategies to mitigate or minimize these potential risks.
Literatur
1.
2.
Huang Y, Li L, Monteleone M et al (2016) Use of anesthesia for imaging studies and interventional procedures in children. J Neurosurg Anesthesiol 28:400–404CrossRef
3.
Wachtel RE, Dexter F, Dow AJ (2009) Growth rates in pediatric diagnostic imaging and sedation. Anesth Analg 108:1616–1621CrossRefPubMed
4.
Cravero JP, Blike GT, Beach M et al (2006) Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the pediatric sedation research consortium. Pediatrics 118:1087–1096CrossRefPubMed
5.
Mellon RD, Simone AF, Rappaport BA (2007) Use of anesthetic agents in neonates and young children. Anesth Analg 104:509–520CrossRefPubMed
6.
Davidson AJ (2011) Anesthesia and neurotoxicity to the developing brain: the clinical relevance. Paediatr Anaesth 21:716–721CrossRefPubMed
7.
Slovis TL (2011) Sedation and anesthesia issues in pediatric imaging. Pediatr Radiol 41:S514–S516CrossRef
8.
Ruess L, O’Connor SC, Mikita CP et al (2002) Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team. Pediatr Radiol 32:505–510CrossRefPubMed
9.
Macias CG, Chumpitazi CE (2011) Sedation and anesthesia for CT: emerging issues for providing high-quality care. Pediatr Radiol 41:S517–S522CrossRef
10.
11.
Starkey E, Sammons HM (2011) Sedation for radiological imaging. Arch Dis Child Educ Pract Ed 96:101–106CrossRefPubMed
12.
Malviya S, Voepel-Lewis T, Tait AR et al (2004) Pentobarbital vs chloral hydrate for sedation of children undergoing MRI: efficacy and recovery characteristics. Paediatr Anaesth 14:589–595CrossRefPubMed
13.
Siddappa R, Riggins J, Kariyanna S et al (2010) High-dose dexmedetomidine sedation for pediatric MRI. Paediatr Anaesth 21:153–158CrossRef
14.
Mallory MD, Baxter AL, Kost SI et al (2009) Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the pediatric sedation research consortium. Paediatr Anaesth 19:601–611CrossRefPubMed
15.
Baxter AL, Mallory MD, Spandorfer PR et al (2007) Etomidate versus pentobarbital for computed tomography sedations. Pediatr Emerg Care 23:690–695CrossRefPubMed
16.
Cutler KO, Bush AJ, Godambe SA et al (2007) The use of a pediatric emergency medicine-staffed sedation service during imaging: a retrospective analysis. Am J Emerg Med 25:654–661CrossRefPubMed
17.
Malviya S, Voepel-Lewis T, Eldevik OP et al (2000) Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth 84:743–748CrossRefPubMed
18.
Newman DH, Azer MM, Pitetti RD et al (2003) When is a patient safe for discharge after procedural sedation? The timing of adverse effect events in 1,367 pediatric procedural sedations. Ann Emerg Med 42:627–635CrossRefPubMed
19.
Kannikeswaran N, Mahajan PV, Sethuraman U et al (2009) Sedation medication received and adverse events related to sedation for brain MRI in children with and without developmental disabilities. Paediatr Anaesth 19:250–256CrossRefPubMed
20.
Sanborn PA, Michna E, Zurakowski D et al (2005) Adverse cardiovascular and respiratory events during sedation of pediatric patients for imaging examinations. Radiology 237:288–294CrossRefPubMed
21.
Coté CJ, Karl HW, Notterman DA et al (2000) Adverse sedation events in pediatrics: analysis of medications used for sedation. Pediatrics 106:633–644CrossRefPubMed
22.
Loepke AW, Soriano SG (2008) An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesth Analg 106:1681–1707CrossRefPubMed
23.
24.
Creeley C, Dikranian K, Dissen G et al (2013) Propofol-induced apoptosis of neurones and oligodendrocytes in fetal and neonatal rhesus macaque brain. Br J Anaesth 110:i29–i38CrossRefPubMedPubMedCentral
25.
Satomoto M, Satoh Y, Terui K et al (2009) Neonatal exposure to sevoflurane induces abnormal social behaviors and deficits in fear conditioning in mice. Anesthesiology 110:628–637CrossRefPubMed
26.
Brambrink AM, Evers AS, Avidan MS et al (2010) Isoflurane-induced neuroapoptosis in the neonatal rhesus macaque brain. Anesthesiology 112:834–841CrossRefPubMedPubMedCentral
27.
Stratmann G, Lee J, Sall JW et al (2014) Effect of general anesthesia in infancy on long-term recognition memory in humans and rats. Neuropsychopharmacology 39:2275–2287CrossRefPubMedPubMedCentral
28.
Takaenoki Y, Satoh Y, Araki Y et al (2014) Neonatal exposure to sevoflurane in mice causes deficits in maternal behavior later in adulthood. Anesthesiology 120:403–415CrossRefPubMed
29.
Jevtovic-Todorovic V, Hartman RE, Izumi Y et al (2003) Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci 23:876–882PubMed
30.
Hansen T (2015) Anesthesia-related neurotoxicity and the developing animal brain is not a significant problem in children. Paediatr Anaesth 25:65–72CrossRefPubMed
31.
Anand KJS (2007) Anesthetic neurotoxicity in newborns: should we change clinical practice? Anesthesiology 107:2–4CrossRefPubMed
32.
Pound P, Bracken MB (2014) Is animal research sufficiently evidence based to be a cornerstone of biomedical research? BMJ 348:g3387CrossRefPubMed
33.
Hays SR, Deshpande JK (2013) Newly postulated neurodevelopmental risks of pediatric anesthesia: theories that could rock our world. J Urol 189:1222–1228CrossRefPubMed
34.
Vutskits L, Xie Z (2016) Lasting impact of general anaesthesia on the brain: mechanisms and relevance. Nat Rev Neurosci 17:705–717CrossRefPubMed
35.
Hansen TG, Flick R (2009) Anesthetic effects on the developing brain: insights from epidemiology. Anesthesiology 110:1–3CrossRefPubMed
36.
Hansen TG (2013) Neurotoxicity, general anesthesia and the developing brain: what have we learned from the human studies so far? Curr Anesthesiol Rep 3:175–183CrossRef
37.
DiMaggio C, Sun LS, Kakavouli A et al (2009) A retrospective cohort study of the association of anesthesia and hernia repair surgery with behavioral and developmental disorders in young children. J Neurosurg Anesthesiol 21:286–291CrossRefPubMedPubMedCentral
38.
DiMaggio C, Sun LS, Li G (2011) Early childhood exposure to anesthesia and risk of developmental and behavioral disorders in a sibling birth cohort. Anesth Analg 113:1143–1151CrossRefPubMedPubMedCentral
39.
Walker K, Halliday R, Holland AJA et al (2010) Early developmental outcome of infants with infantile hypertrophic pyloric stenosis. J Pediatr Surg 45:2369–2372CrossRefPubMed
40.
Hansen TG, Pedersen JK, Henneberg SW et al (2013) Educational outcome in adolescence following pyloric stenosis repair before 3 months of age: a nationwide cohort study. Paediatr Anaesth 23:883–890CrossRefPubMed
41.
Bong CL, Allen JC, Kim JTS (2013) The effects of exposure to general anesthesia in infancy on academic performance at age 12. Anesth Analg 117:1419–1428CrossRefPubMed
42.
Bartels M, Althoff RR, Boomsma DI (2009) Anesthesia and cognitive performance in children: no evidence for a causal relationship. Twin Res Hum Genet 12:246–253CrossRefPubMed
43.
Hansen TG, Pedersen JK, Henneberg SW et al (2011) Academic performance in adolescence after inguinal hernia repair in infancy. Anesthesiology 114:1076–1085CrossRefPubMed
44.
Kalkman CJ, Peelen L, Moons KG et al (2009) Behavior and development in children and age at the time of first anesthetic exposure. Anesthesiology 110:805–812CrossRefPubMed
45.
Wilder RT, Flick RP, Sprung J et al (2009) Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology 110:796–804CrossRefPubMedPubMedCentral
46.
Flick RP, Katusic SK, Colligan RC et al (2011) Cognitive and behavioral outcomes after early exposure to anesthesia and surgery. Pediatrics 128:e1053–e1061CrossRefPubMedPubMedCentral
47.
Ing C, DiMaggio C, Whitehouse A et al (2012) Long-term differences in language and cognitive function after childhood exposure to anesthesia. Pediatrics 130:e476–e485CrossRefPubMed
48.
Taghon TA, Masunga AN, Small RH et al (2015) A comparison of functional magnetic resonance imaging findings in children with and without a history of early exposure to general anesthesia. Paediatr Anaesth 25:239–246CrossRefPubMed
49.
Backeljauw B, Holland SK, Altaye M et al (2015) Cognition and brain structure following early childhood surgery with anesthesia. Pediatrics 136:e1–12CrossRefPubMedPubMedCentral
50.
Block RI, Thomas JJ, Bayman EO et al (2012) Are anesthesia and surgery during infancy associated with altered academic performance during childhood? Anesthesiology 117:494–503CrossRefPubMed
51.
Williams RK, Black IH, Howard DB et al (2014) Cognitive outcome after spinal anesthesia and surgery during infancy. Anesth Analg 119:651–660CrossRefPubMed
52.
53.
Davidson AJ, Disma N, de Graaff JC et al (2016) Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet 387:239–250CrossRefPubMed
54.
Chinn GA, Sasaki Russel JM, Sall JW (2016) Is a short anesthetic exposure in children safe? Time will tell: a focused commentary of the GAS and PANDA trials. Ann Transl Med 4:408–413CrossRefPubMedPubMedCentral
55.
Jevtovic-Todorovic V, Absalom AR, Blomgren K et al (2013) Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg seminar. Br J Anaesth 111:143–151CrossRefPubMedPubMedCentral
56.
Flick RP, Warner DO (2012) A users’ guide to interpreting observational studies of pediatric anesthetic neurotoxicity. Anesthesiology 117:459–462CrossRefPubMedPubMedCentral
57.
58.
59.
Rosenberg DR, Sweeney JA, Gillen JS et al (1997) Magnetic resonance imaging of children without sedation: preparation with simulation. J Am Acad Child Adolesc Psychiatry 36:853–859CrossRefPubMed
60.
Sury MRJ, Harker H, Begent J et al (2005) The management of infants and children for painless imaging. Clin Radiol 60:731–741CrossRefPubMed
61.
de Bie HMA, Boersma M, Wattjes MP et al (2010) Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr 169:1079–1085CrossRefPubMedPubMedCentral
62.
Hallowell LM, Stewart SE, de Amorem e Silva CT et al (2008) Reviewing the process of preparing children for MRI. Pediatr Radiol 38:271–279CrossRefPubMed
63.
Gale C, Jeffries S, Logan KM et al (2013) Avoiding sedation in research MRI and spectroscopy in infants: our approach, success rate and prevalence of incidental findings. Arch Dis Child Fetal Neonatal Ed 98:F267–F268CrossRefPubMed
64.
Edwards AD, Arthurs OJ (2011) Paediatric MRI under sedation: is it necessary? What is the evidence for the alternatives? Pediatr Radiol 41:1353–1364CrossRefPubMed
65.
Khan JJ, Donnelly LF, Koch BL et al (2007) A program to decrease the need for pediatric sedation for CT and MRI. Appl Radiol 36:30–33
66.
Sanders RD, Xu J, Shu Y et al (2009) Dexmedetomidine attenuates isoflurane-induced neurocognitive impairment in neonatal rats. Anesthesiology 110:1077–1085CrossRefPubMed
67.
Mason KP, Zurakowski D, Zgleszewski SE et al (2008) High dose dexmedetomidine as the sole sedative for pediatric MRI. Paediatr Anaesth 18:403–411CrossRefPubMed
Metadaten
Titel
Pediatric anesthesia and neurotoxicity: what the radiologist needs to know
verfasst von
Katherine Barton
Joshua P. Nickerson
Timothy Higgins
Robert K. Williams
Publikationsdatum
03.05.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 1/2018
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-017-3871-4

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