Schädigt die Narkose das Gehirn von Kindern?

Jöhr, Martin

doi:10.1007/s00101-006-0985-8

Cited by 6 publications

(2 citation statements)

References 17 publications

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“…In addition, there is an ongoing and controversial discussion concerning the potential of anesthetic agents to induce neurodegenerative changes in the developing brain (7,8). The brain is most susceptible during the formation of synapses, which takes place over a few weeks in rats but from the 26th week of gestation up to the second year of life in humans.…”

Section: Agementioning

confidence: 99%

Ear Surgery in Infants Under One Year of Age

Jöhr¹,

Ho²,

Wagner³

et al. 2008

Otology &Amp; Neurotology

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Section: Agementioning

confidence: 99%

Ear Surgery in Infants Under One Year of Age

Jöhr¹,

Ho²,

Wagner³

et al. 2008

Otology &Amp; Neurotology

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“…Die aktuellen Diskussionen über das Potenzial von Anästheti-ka, im Tierexperiment beim sich entwickelnden Gehirn Zelluntergang (Apoptose) zu induzieren [30] oder über mög-liche Spätfolgen langer und tiefer Narkosen [43], sind für die Wissenschaft wichtig. Sie dürfen aber keinesfalls dazu verleiten, kleinen Kindern im klinischen Alltag eine gut gesteuerte und klar indizierte Anästhesie vorzuenthalten [5,15,35]. Alkohol, Antiepileptika, Hypoxie und Nahrungsmangel können ebenfalls Apoptose induzieren [49].…”

Section: Allgemeine Prinzipienunclassified

Awareness

Jöhr

2006

Anaesthesist

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Intraoperative awareness has been reported to occur in 0.8-5.0% of paediatric patients undergoing anaesthesia and, therefore, seems to be more common than in adults (incidence 0.1-0.2%). In adult patients, the consequences of intraoperative awareness are well known and can be severe, in children, however, they have not yet been adequately studied. The causes for intraoperative awareness can be divided into three broad categories: First, no or only a light anaesthetic is given on purpose, second, an insufficient dose of an anaesthetic is given inadvertently, third, there is equipment malfunction or the anaesthesiologist makes an error. Unfortunately, especially in young children, painful interventions are still performed without adequate analgesia, e.g. awake intubation or fracture manipulation under midazolam sedation alone. The key issue is, however, that pharmacokinetics and pharmacodynamics change enormously from the 500 g preterm baby to the adolescent patient. Adequate dosing is much more difficult in paediatric patients compared to standard adult surgical patients. Solid knowledge of the pharmacokinetic and pharmacodynamic characteristics of commonly used drugs in different paediatric age groups, as well as aiming for perfection in daily care will help to reduce the incidence of awareness. Methods for monitoring the depth of hypnosis, e.g. the bispectral index, will be used increasingly, at least in children above 1 year of age. In addition to clinical parameters, they will hopefully help to further reduce the incidence of intraoperative awareness.

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Anatomische und physiologische Besonderheiten

Jöhr¹

2009

Kinderanästhesie

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Schädigt die Narkose das Gehirn von Kindern?

Cited by 6 publications

References 17 publications

Ear Surgery in Infants Under One Year of Age

Ear Surgery in Infants Under One Year of Age

Awareness

Anatomische und physiologische Besonderheiten

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