Anesthesia and perioperative stress Consequences on neural networks and postoperative behaviors

被引:47
作者
Borsook, David [1 ]
George, Edward [2 ]
Kussman, Barry [3 ]
Becerra, Lino [1 ]
机构
[1] Childrens Hosp Boston, Dept Radiol, Boston, MA USA
[2] Massachusetts Gen Hosp, Dept Anesthesiol, Boston, MA 02114 USA
[3] Childrens Hosp Boston, Dept Anesthesiol, Boston, MA USA
关键词
Functional imaging; Pain; Stress; Surgery; Awareness; Cytokines; Anesthetics; MULTIPLE NOXIOUS STIMULI; GENERAL-ANESTHESIA; BISPECTRAL INDEX; APOPTOTIC NEURODEGENERATION; CHRONIC PAIN; ISOFLURANE/OXYGEN ANESTHESIA; PROINFLAMMATORY CYTOKINES; INTRAOPERATIVE AWARENESS; MOLECULAR-MECHANISMS; CORTISOL RESPONSES;
D O I
10.1016/j.pneurobio.2010.08.006
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Anesthesia is a state of drug-induced unconsciousness with suppression of sensory perception and consists of both hypnotic and analgesic components The anesthesiologist monitors the clinical response to noxious stimuli and adjusts drug dosage(s) to achieve an adequate depth of anesthesia with the aim of reducing operative stress Acute stress in the perioperative period has four major contributors anxiety pain the surgical stress response and the potential neurotoxicity of anesthetic agents Any or all of these may act deleteriously on multiple systems in the brain and have known significant effects on brain regions such as the hippocampus and the hypothalamic-pituitary-adrenal axis Perioperative stress on the nervous system and the resultant central nervous system (CNS) changes are likely to be causative for altered behaviors that are seen postoperatively including chronic pain posttraumatic stress disorder and learning difficulties Improving the ability of the anesthesiologist to control all four components of acute perioperative stress could potentially reduce the negative impact of surgery on the brain Currently there is no objective measurement for any of these stressors The development and application of objective measures for perioperative stressors is the first step towards controlling these risk factors and eliminating or reducing their serious postoperative consequences In this paper we review known and likely effects of perioperative stressors on brain systems and how they may play a significant role in altered postoperative behaviors We discuss the role of current (and developing) measures of brain function and their potential for monitoring perioperative stress with an emphasis on functional neuroimaging (C) 2010 Elsevier Ltd All rights reserved
引用
收藏
页码:601 / 612
页数:12
相关论文
共 195 条
[1]  
Adam Naureen, 2004, Semin Cardiothorac Vasc Anesth, V8, P9, DOI 10.1177/108925320400800103
[2]   Xenon-induced changes in CNS sensitization to pain [J].
Adolph, Oliver ;
Koester, Sarah ;
Georgieff, Michael ;
Baeder, Stefan ;
Foehr, Karl J. ;
Kammer, Thomas ;
Herrnberger, Baerbel ;
Groen, Georg .
NEUROIMAGE, 2010, 49 (01) :720-730
[3]   Cerebrovascular reactivity to hypercapnia in migraine patients measured with near-infrared spectroscopy [J].
Akin, Ata ;
Bilensoy, Didem .
BRAIN RESEARCH, 2006, 1107 :206-214
[4]   Consciousness and Anesthesia [J].
Alkire, Michael T. ;
Hudetz, Anthony G. ;
Tononi, Giulio .
SCIENCE, 2008, 322 (5903) :876-880
[5]   Anesthetic neurotoxicity in newborns - Should we change clinical practice? [J].
Anand, Kanwaljeet J. S. .
ANESTHESIOLOGY, 2007, 107 (01) :2-4
[6]  
ANAND KJS, 2000, PAIN NEONATES
[7]   Surgical trauma and immunosuppression: pathophysiology and potential immunomodulatory approaches [J].
Angele, MK ;
Chaudry, IH .
LANGENBECKS ARCHIVES OF SURGERY, 2005, 390 (04) :333-341
[8]   Chronic back pain is associated with decreased prefrontal and thalamic gray matter density [J].
Apkarian, AV ;
Sosa, Y ;
Sonty, S ;
Levy, RM ;
Harden, RN ;
Parrish, TB ;
Gitelman, DR .
JOURNAL OF NEUROSCIENCE, 2004, 24 (46) :10410-10415
[9]   Anesthesia awareness and the bispectral index [J].
Avidan, Michael S. ;
Zhang, Lini ;
Burnside, Beth A. ;
Finkel, Kevin J. ;
Searleman, Adam C. ;
Selvidge, Jacqueline A. ;
Saager, Leif ;
Turner, Michelle S. ;
Rao, Srikar ;
Bottros, Michael ;
Hantler, Charles ;
Jacobsohn, Eric ;
Evers, Alex S. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (11) :1097-1108
[10]   Anti-depressant and anxiolytic like behaviors in PKCI/HINT1 knockout mice associated with elevated plasma corticosterone level [J].
Barbier, Elisabeth ;
Wang, Jia Bei .
BMC NEUROSCIENCE, 2009, 10