Perioperative anesthetic exposure and the neurodevelopmental status of 1 year old baby underwent neonatal cardiac surgery.
10.11817/j.issn.1672-7347.2015.11.012
- Author:
Xuejun CHEN
1
;
Yongling WAN
1
;
Kailan WEN
1
;
Tao LIANG
1
;
Tao LIN
1
;
Peng LI
1
Author Information
1. Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
- Publication Type:Journal Article
- MeSH:
Anesthetics;
adverse effects;
Benzodiazepines;
adverse effects;
Cardiac Surgical Procedures;
Child Development;
drug effects;
Cohort Studies;
Fentanyl;
adverse effects;
Humans;
Infant;
Infant, Newborn;
Length of Stay;
Linear Models;
Magnetic Resonance Imaging;
Neuroimaging
- From:
Journal of Central South University(Medical Sciences)
2015;40(11):1234-1238
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To determine the association between perioperative anesthetic exposure and neurodevelopmental status at age 1 year old baby underwent complex cardiac surgery.
METHODS:One hundred and fifteen infants were selected from Sichuan People's Hospital. A cohort study was conducted on neonates who underwent complex cardiac surgery. The babies were performed brain MRI before the operation and 7 days after the operation, and 12-month neurodevelopmental testing was carried out with Bayley Scales of Infant and Toddler Development (the third Edition, Bayley-III). Doses of volatile anesthetics (VAA), benzodiazepines, and opioids were determined during the 12 months. The association between peri-operative anesthetic exposure and 12-month neurodevelopmental status were analyzed.
RESULTS:A total of 92 infants were enrolled for the final analysis. Their Bayley-III scores of cognitive, language, and movement were as follows: 104.2 ± 14.7, 85.6 ± 11.3, and 86.9 ± 13.5, respectively. MRI results showed that 17 infants showed pre-operative brain injury and 25 infants showed new post-operative injury. After performing the analysis of stepwise multivariable linear regression, MRI showed the factors affecting neurodevelopment of newborn include the new post-operative injury, higher VAA exposure, fentanyl dose, benzodiazepine dose, ICU length of stay, pre-operative mean regional cerebral oxygen saturation (rSO₂), and abnormal chromosomes.
CONCLUSION:VAA exposure and ICU length of stay are associated with poor neurodevelopmental scores at 12 months of age. Further studies need to identify the potential modifiable factors in the peri-operative care of neonates to improve neurodevelopmental outcomes.
