We read with great interest the recent editorial concerning anesthetic neurotoxicity by Drs. Vutskits and Culley. We agree with their interpretation that it appears a short exposure to general anesthesia is unlikely to cause clinically significant neurocognitive deficits in our youngest patients. However, for our group, choosing a form of awake regional anesthesia for appropriate surgeries has never been about the theoretical risk of neurotoxicity. Rather, it involves a conscious choice to work as a joint surgical and anesthetic team to provide a technique that has a proven lower risk of hypotension, apnea, bradycardia and laryngospasm while producing lower pain scores in the postanesthesia care unit and shorter anesthesia control times.