Few if any issues received more attention in the field of pediatric perioperative care over the past decade than developmental anesthesia neurotoxicity. While the possibility of a plausible association between anesthesia and postoperative personality changes in children was first hypothesized more than 60 years ago,1 substantial concern on this subject has been ignited by seminal laboratory work, conducted 50 years later, where exposure of newborn rats to a mixture of anesthetics induced widespread apoptosis and persistent cognitive deficits in these animals.2 The initial mistrust and rejection generated by this publication in the anesthesia community have been rapidly transformed into an important public health concern after the robust confirmation of developmental anesthesia neurotoxicity in a variety of experimental models and, most importantly, with the availability of human epidemiological data suggesting an association between early life anesthesia exposure and subsequent neurocognitive disturbances.
- When Your Child Needs Surgery, Don’t Fear Anesthesia, Says American Society of Anesthesiologists
- Neurotoxicity of Inhalation Anesthetics in the Neonatal Rat Brain: Effects on Behavior and Neurodegeneration in the Piriform Cortex.
- Does pediatric anesthesia cause brain damage? Addressing parental and provider concerns in light of compelling animal studies and seemingly ambivalent human data.
- The postoperative effect of sevoflurane inhalational anesthesia on cognitive function and inflammatory response of pediatric patients.
- General anesthetics and cytotoxicity: possible implications for brain health.