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Кому интересно, может углубиться в полнотекстовое повествование, но суть в заключении (выделено мной):
Currently, volatile anesthetics-induced neuroprotection and neurotoxicity are two hot research topics. These two effects seem contradictory to each other and each is supported by sufficient laboratory studies. However, clinical data to support the neuroprotective effects are relatively weak. There are no clinical data yet to suggest volatile anesthetics-induced neurotoxicity. из Are volatile anesthetics neuroprotective or neurotoxic? [Ссылки доступны только зарегистрированным пользователям ]
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Искренне, Вадим Валерьевич. |
#2
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Цитата:
Вы анестезиолог? Каковы Ваши наблюдения поэтому вопросу? |
#3
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Цитата:
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Искренне, Вадим Валерьевич. |
#4
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All routinely used sedatives and anesthetics have been found to be neurotoxic in a wide variety of animal species, including nonhuman primates.
Several epidemiologic human studies have observed an association between anesthesia exposure in patients younger than 3 to 4 years and subsequent learning disabilities and language abnormalities, whereas others have not found this link. It remains unresolved whether anesthetic exposure or other factors, such as the underlying medical condition, surgery, inflammatory response, pain, physiologic abnormalities during surgery, or other unknown factors, are causative for the observed abnormalities. --- Anesthetic Neurotoxicity Anesthesiology Clinics, Volume 32, Issue 1, March 2014, Pages 133–155
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Искренне, Вадим Валерьевич. |
#5
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Обзор Neurotoxicity of Anesthetic Drugs in the Developing Brain от врача-анестезиолога из Калифорнии, доступен для полного прочтения по ссылке:
[Ссылки доступны только зарегистрированным пользователям ] важные фрагменты оттуда, имеющие непосредственное отношение к клинической медицине (педиатрической анестезиологии) на сегодняшний день: ...the human literature is controversial as to whether anesthesia in infancy causes cognitive problems later in life. Furthermore, it is unclear what the period of vulnerability to anesthetic neurotoxicity is. We do not know whether there is a safe anesthetic technique or duration. The specific cognitive deficit caused by anesthesia, if any, that may underlie such outcomes as learning disabilities, has not been identified. None of the studies, alone or in combination, form a basis for informing clinical practice. Knowledge of developmental anesthetic neurotoxicity is rapidly accumulating but clarity about the mechanisms or the significance of this phenomenon for human pediatric anesthesia is not emerging. A change in clinical anesthetic practice is unwarranted, based on the currently available human literature and should probably not be based on animal studies. Most importantly, a change in clinical practice requires a superior alternative to current practice, and no evidence guides us as to what this might be. More research is urgently needed to determine whether anesthesia impairs brain function in humans, what the specific deficit is, and how it can be prevented and/or treated.
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Искренне, Вадим Валерьевич. |
#6
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Авторы-специалисты в этой области из Китая так бесхитростно и говорят: Interestingly, most anesthetics (volatile anesthetics, ketamine or propofol) have dual effects on the developing brain; they can be neuroprotective and neurotoxic depending on the context. The details of this dual effect however, are still unknown. (Большинство анестетиков оказывают двоякое действие - нейротоксичное и нейропротективное, все зависит, как Вы хотите преподать данную информацию в статье)
Mechanistic Insights into Neurotoxicity Induced by Anesthetics in the Developing Brain [Ссылки доступны только зарегистрированным пользователям ] ПыСы. Сегодня против кого боремся/дружим: глобальное потепление? ГМО-продукты? а может коллоиды против кристаллоидов??? World J Crit Care Med. 2014 Feb 4;3(1):24-33. Controversies in fluid therapy: Type, dose and toxicity. [Ссылки доступны только зарегистрированным пользователям ]
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Искренне, Вадим Валерьевич. |
#7
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Цитата:
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#8
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О токсичности местных анестетиков:
Local Anesthetic Neurotoxicity: Clinical Injury and Strategies That May Minimize Risk [Ссылки доступны только зарегистрированным пользователям ] полный текст о Local anaesthetic toxicity прикреплен внизу
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Искренне, Вадим Валерьевич. |