For decades, the question of neonatal anesthetic toxicity has variably met with passionate concern, perplexity, or indifference among the anesthesia practitioner and investigator communities. What began as a laboratory observation and academic curiosity of unknown clinical relevance, leading to clinical research and clinical concern, was elevated to a real clinical predicament by an unexpected 2016 U.S. Food and Drug Administration (FDA) Safety Announcement declaring that “repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children’s brains,” with admonitions to healthcare professionals, parents, pregnant women, and caregivers. This was followed in 2017 by FDA–approved formalized changes to several drug labels to memorialize this warning. The aftermath has seen heightened consternation and confusion, with variable response among parents, practitioners, regulators, anesthesiology societies, healthcare institutions, and their risk managers, as well as changes (or not) in informed consent, and several position statements and commentaries. Having allowed this initial flurry to subside, Anesthesiology this month features two comprehensive review articles and accompanying editorials on anesthetic developmental neurotoxicity in animals and in humans.
Recent Posts
- 2024 Annual Meeting, presented by the International Anesthesia Research Society (IARS) and the Society of Critical Care Anesthesiologists (SOCCA), May 17-19, 2024, Seattle, WA
- Society for Pediatric Anesthesia (SPA) and the American Academy of Pediatrics (AAP), Pediatric Anesthesiology 2024, April 12-14, 2024, Anaheim, CA
- Duration of Fetoscopic Spina Bifida Repair Does Not Affect the Central Nervous System in Fetal Lambs.
- Melatonin attenuates sevoflurane-induced hippocampal damage and cognitive deficits in neonatal mice by suppressing CypD in parvalbumin neurons.
- Engeletin Ameliorates Sevoflurane-Induced Cognitive Impairment by Activating PPAR-Gamma in Neonatal Mice.