Long-term Effects of Early Exposure to Stress, Pain, Opioids and Anaesthetics on Pain Sensitivity and Neurocognition

Title:Long-term Effects of Early Exposure to Stress, Pain, Opioids and Anaesthetics on Pain Sensitivity and Neurocognition

Volume: 23 Issue: 38

Author(s): Gerbrich E. van den Bosch, Monique van Dijk, Dick Tibboel and Jurgen C. de Graaff*

Affiliation:

• Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, Rotterdam,Netherlands

Keywords: Anaesthetics, children, opioids, pain, long-term outcome, stress.

Abstract: Background Experimental studies have shown that neonatal exposure to stress, pain, opioids and anaesthetics may cause histologic and morphologic changes in the central nervous system with associated functional and behavioural changes in the long term. An important question is whether this holds true for humans also – and in particular for sick neonates who often are exposed to pain and receive anaesthetics and sedatives.

Methods In this narrative review, we evaluate the effects of neonatal exposure to stress, pain, opioids and anaesthetics in infancy and childhood in animals and in preterm born and term born humans on pain sensitivity, brain morphology, cognition and behaviour later in life.

Results In animals, neonatal exposure to stress, pain, opioids and early exposure to anaesthetics are associated with neurodegeneration and cognitive problems later in life. Human studies mainly focus on pain sensitivity, cognition and behaviour and find contradictory outcomes. Dramatic long-term effects found in animal studies could not be confirmed in human.

Conclusion While studies in animals suggest neurotoxic effects of early exposure to stress, pain, opioids and anaesthetics, these effects seem clinically less relevant in humans. A possible reason is that the latter often receive opioids in the presence of pain and opioids and anaesthetics in balanced therapeutic dosages and with adequate monitoring of physiological parameters, in contrast to animal studies.

Cite this article as:

van den Bosch E. Gerbrich, Dijk van Monique , Tibboel Dick and de Graaff C. Jurgen*, Long-term Effects of Early Exposure to Stress, Pain, Opioids and Anaesthetics on Pain Sensitivity and Neurocognition, Current Pharmaceutical Design 2017; 23 (38) . https://dx.doi.org/10.2174/1381612823666170926150259

DOI https://dx.doi.org/10.2174/1381612823666170926150259	Print ISSN 1381-6128
Publisher Name Bentham Science Publisher	Online ISSN 1873-4286