Article Review: Effects of Anesthesia

The article "Does general anesthesia affect neurodevelopment of infants and children?" the authors, Mary McCann and Sulpicio Soriano examine the evidence for the functional and neurocognitive impacts of the anesthetics widely used I, laboratory models. The research study reported in the journal article aimed at establishing the connection between general anesthesia and abnormal development of the central nervous system that leads to neurocognitive impairments in the business model. Furthermore, it utilizes the existing data to discuss the behavioral changes among children after being directly exposed to general anesthetics. On the other end, this journal article, which targets healthcare providers, including surgeons, physicians, and pediatricians, focuses on establishing the relevance of this subject to clinical care to improve patients' safety. The professional material aims to raise the emerging concerns, expand the clinical knowledge of healthcare providers, and reassure them of the short- and long-term impacts of anesthesia on young patients.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

McCann and Soriano conducted a detailed analysis of existing articles at PubMed from January 1946 to June 2019 to develop their argument and provide answers to the specific research questions (McCann & Soriano, 2019). The primary research question is, “given the reports of harm are limited to short anesthetics and surgery, are prolonged or repetitive exposures safe” Also, at what age are children most vulnerable to general anesthetic neurotoxicity?” Lastly, which children are at the highest risk for general anesthetic neurotoxicity?

The authors’ selection process favored articles specific to human beings, peer-reviewed, and published in the past ten years. Besides, for clinical reports, the study prioritized randomized prospective trials and preferred extensive cohort studies over the small ones. McCann and Soriano also used consensus statements, guidelines, systematic reviews, ad public statements from the European Society of Pediatric Aesthesia and the United States (U.S) Food and Drug Administration (FDA).

According to McCann and Soriano (2019), general anesthesia removes sensory input and suppresses regular neural traffic (McCann & Soriano, 2019). As a result, it reduces the trophic support needed for neurogenesis and context-dependent modulation of neuroplasticity. Anesthesia exposure in childhood can result in either or both immediate and long-term neurocognitive changes. For instance, it causes the development of anesthesia emergence delirium (AED): a disassociated state of mind where a child is irritable, inconsolable, uncooperative, and continuously crying or moaning (McCann & Soriano, 2019).

As indicated in the article and supported by Barreto et al. (2017), this phenomenon is prevalent to children around the age of 2 to 5 years. It occurs 10-30 minutes after a surgical procedure. For children, the risk factors for the development of AED relates to the type of surgery, age, patient anxiety, preexisting behaviors, and type of interaction with healthcare providers. For instance, ophthalmology and otorhinolaryngology procedures have a higher incidence of post-care agitation, and children of age five or below are at more risks (McCann & Soriano, 2019). AED’s incidence can be reduced by the utilization of intraoperative treatment techniques using analgesic. However, the article only covered pharmacological interventions but failed to mention that behavior management is an ideal strategy to handle emergent delirium (Mason, 2017).

The structure of the brain is known to develop throughout one's childhood, therefore making the period vital and marks the peak of development for later cognition, language, and overall social behaviors. Human anesthetic induces different levels of neurotoxicity based on the difference in age. For instance, a study conducted on two to four years old children revealed that multiple rounds of exposure to anesthetic are associated with learning difficulties and underachievement on academic matters (Wu et al., 2019).

As of 2018, the U.S has over six million children who receive anesthesia annually, and close to 2.5 million of the total number are children aged more than 36 months (Andropoulous, 2018).Children, infants, and fetuses are vulnerable to anesthetic neurotoxicity because the stages are crucial for one’s life since they are characterized by brain development.

Therefore, long-lasting exposure to general anesthetics leads to subsequent lasting behavioral, cognitive, and memory deficiency. However, the research reported in this article does not address the impacts of general anesthetics on adolescents, leading to neuronal apoptosis or neurodegeneration. On top of being a crucial stage in life, marking a transition from childhood to adulthood, adolescents age enables the children to learn more about themselves.

In general, the journal article provides an in-depth analysis of the impacts of general anesthesia on children, which is useful to healthcare as it enables healthcare providers to understand the subject for both adults and children. Furthermore, the authors highlighted several interventions that can be adopted to reduce or eliminate the phenomenon’s effects on young patients. In doing so, this professional and academic material is likely to promote patient safety, thereby improving nursing practice. Besides, the authors provided useful information that acts as the foundation and starting point for future research practices on the topic. Also, knowledge from the article can help patients and their close families to understand the consequences of exposure to anesthesia and, therefore, make the appropriate decisions to prevent it before it occurs.

References

Andropoulos, D. B. (2018). Effect of Anesthesia on the Developing Brain: Infant and Fetus. Fetal Diagnosis and Therapy, 43(1), 1–11. https://doi.org/10.1159/000475928

Barreto, A. C. T. P., Paschoal, A. C. R. da R., Farias, C. B., Borges, P. S. G. N., Andrade, R. G. A. da C., & de Orange, F. A. (2018). Risk factors associated with anesthesia emergence delirium in children undergoing outpatient surgery. Brazilian Journal of Anesthesiology (English Edition), 68(2), 162–167. https://doi.org/10.1016/j.bjane.2017.11.002

Mason, K.P. (2017). Pediatric emergence delirium: A comprehensive review and interpretation of the literature. British Journal of Anesthesia, 118)3), 335-343. doi: 10.1093/bja/aewn,

M.E., & Soriano, S.G. (2019). Does general anesthesia affect neurodevelopment in infants and children? BMJ, 1-11. https://doi.org/10.1136/bmj.l6459

McCann, M. E., & Soriano, S. G. (2019). Does general anesthesia affect neurodevelopment in infants and children? BMJ, 33, l6459. https://doi.org/10.1136/bmj.l6459

Wu, L., Zhao, H., Weng, H., & Ma, D. (2019). Lasting effects of general anesthetics on the brain in the young and elderly: "mixed picture" of neurotoxicity, neuroprotection, and cognitive impairment. Journal of Anesthesia, 33, 321--335. https://doi.org/10.1007/s00540-019-02623-7