M Weiss. T G Hansen. T Engelhardt

Annually, millions of neonates and young infants worldwide are submitted to surgery and general anaesthesia. The safety of providing anaesthesia for these patients has recently been cast into doubt based on a large number of animal studies demonstrating that anaesthetic exposure during a vulnerable period of brain development (ie, brain growth spurt) causes neurodegeneration (neuroapoptosis) and abnormal synaptic development with functional deficits in learning and behaviour later in life.1–4 Emerging robust human data, however, do not support this laboratory evidence but reveal other factors that more importantly impact long-term neurocognition.5–8 The aim of this article is to describe the important perioperative safety issues that matter most to children undergoing surgery and influence outcome in perioperative care.

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