Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC139110.15690/vramn1391PEDIATRICS: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ПЕДИАТРИИResearch ArticleEffect of Anesthesia in the Ante- and Intranatal Periods of Development on the Cognitive Status of Children Aged from 0 to 3 YearsВлияние анестезии в анте- и интранатальном периодах развития на когнитивный статус детей в возрасте от 0 до 3 летhttps://orcid.org/0000-0002-2131-48132225-1630AleksandrovichYury S.АлександровичЮрий Станиславович
Russian Federation

MD, PhD, Professor

д.м.н., профессор

jalex1963@mail.ruhttps://orcid.org/0000-0002-1488-47461604-2157GorkovayaIrina A.ГорьковаяИрина Алексеевна
Russian Federation

PhD in Psychological Sciences, Professor

д.психол.н., профессор

iralgork@mail.ruhttps://orcid.org/0000-0001-8389-22759471-8985MiklyaevaAnastasia V.МикляеваАнастасия Владимировна
Russian Federation

PhD in Psychological Sciences, Associate Professor

д.психол.н., доцент

a.miklyaeva@gmail.comSaint Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университетHerzen State Pedagogical University of RussiaРоссийский государственный педагогический университет им. А.И. Герцена071220207555325400207202020102020Copyright ©; 2020, "Paediatrician" Publishers LLCCopyright ©; 2020, Издательство "Педиатръ"2020"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/1391

The article presents the results of a systematic review of publications aimed at analizing the effects of anesthesia during ante- and intranatal periods of development on the cognitive status of infants and young children. The search for publications was carried out by analyzing electronic bibliographic databases Web of Science and PubMed. The analysis revealed five factors, which determine the effects of ante- and intranatal anesthesia on the cognitive development of children: the type of anesthesia, the type of anesthetic, the period of child’s development, the frequency and duration of exposure as well as the dosage and concentration of the substance. Such cognitive functions as memory, learning ability, speech, perceptual processes and motor activity as a predictor for intelligence formation in early childhood are the most vulnerable to the effects of ante- and intranatal anesthesia. The analysis led to the conclusion that regional anesthesia is the safest option of analgesia for operative delivery and non-surgical operations in pregnant women (in terms of the risks of neurocognitive development disorders in children). In the case of general anesthesia, the lowest risks of negative consequences for cognitive status of a child during early childhood are associated with the exposure of sevoflurane.

В статье представлены результаты систематического обзора публикаций, посвященных проблеме влияния анестезии, воздействующей в анте- и интранатальном периодах развития на когнитивный статус младенцев и детей раннего возраста. Поиск публикаций осуществлялся посредством анализа электронных библиографических баз данных Web of Science и PubMed. В результате анализа выявлено пять групп факторов, которые определяют характер анте- и интранатального влияния анестезии на когнитивный статус детей раннего возраста: вид анестезии, тип анестетика, период развития, на который приходится его воздействие, частота и длительность воздействия, а также дозировка и концентрация вещества. Установлено, что наиболее уязвимы к воздействию анте- и интранатальной анестезии такие когнитивные функции, как память и способность к обучению, речь и перцептивные процессы, а также моторная активность, которая в раннем детстве выступает условием становления интеллекта. Констатируется, что при оперативном родоразрешении и неакушерских операциях у беременных наиболее безопасным вариантом обезболивания (с точки зрения рисков нарушений нейрокогнитивного развития ребенка) является регионарная анестезия. В случае общей анестезии наименьшие риски негативных последствий для когнитивного статуса ребенка в период раннего детства связаны с применением севофлурана.

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