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SmartTots and IARS News, Press Releases and Events

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SmartTots – Perspectives from the Front Lines

Millions of children undergo surgery annually. Recent studies suggest there may be reason for concern. This video, featuring Dr. Dean Andropoulos, Dr. Peter Davis, and Dr. Caleb Ing, provides a summary as to why research is needed and the type that is needed.

SmartTots to Help Make Anesthetics and Sedatives Safer for Children

Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the Food and Drug Administration, and Dr. Michael Roizen, of the International Anesthesia Research Society, unveil a new partnership that aims to make anesthesia safer for children.

Pediatric Anesthesia Questions and Myths-Mayo Clinic

Dr. Randall Flick at Mayo Clinic “debunks myths” and answers common questions raised by parents in regard to anesthesia.

The Effect Of General Anesthesia On The Developing Brain: Appreciating Parent Concerns While Allaying Their Fears

More than one million children under the age of five undergo surgery annually in the United States. The most common procedures are myringotomy tubes, tonsillectomy/adenoidectomy, hernia repairs, and circumcisions. Recently, the issue of anesthesia-related neurotoxicity has been in the media limelight, and parents are appropriately fearful about the effects of general anesthesia on their child’s brain development.

CORRESPONDENCE: Can population cohort studies assess the long‐term impact of anesthesia in children?

We were interested to read the study by Schneuer et al1 looking at whether anesthesia in young children impacts on subsequent developmental assessment or school performance, and applaud their efforts to further examine what is a very important question for anesthetists, surgeons and parents. We feel that the study adds to the growing body of evidence that unnecessary multiple or prolonged general anesthetics should be avoided in early life.

A Systematic Review and Narrative Synthesis on the histological and neurobehavioral long term effects of dexmedetomidine

Recent experimental studies suggest that currently used anesthetics have neurotoxic effects on young animals. Clinical studies are increasingly published about the effects of anesthesia on the long term outcome, providing contradictory results. The selective alpha-2 adrenergic receptor agonist dexmedetomidine has been suggested as an alternative non-toxic sedative agent.

Fundamentals of fetal toxicity relevant to sevoflurane exposures during pregnancy

Over the last three decades, advances in medical and surgical techniques have proven life saving and life-improving for young children. Consequently, early and repeated exposure to general anesthetics in childhood has increased. However, accumulating evidence suggests that general anesthetics may be neurotoxic in children. Of particular concern is the neurotoxicity fetuses may suffer from maternal exposure to sevoflurane during surgeries and fetal intervention procedures performed during the second trimester, as this can cause neurodevelopmental impairment in offspring.

An Open Label Pilot Study of a Dexmedetomidine-Remifentanil-Caudal Anesthetic for Infant Lower Abdominal/Lower Extremity Surgery: The T REX Pilot Study

Concern over potential neurotoxicity of anesthetics has led to growing interest in prospective clinical trials using potentially less toxic anesthetic regimens, especially for prolonged anesthesia in infants. Preclinical studies suggest that dexmedetomidine may have a reduced neurotoxic profile compared to other conventional anesthetic regimens; however, coadministration with either anesthetic drugs (eg, remifentanil) and/or regional blockade is required to achieve adequate anesthesia for surgery. The feasibility of this pharmacological approach is unknown. The aim of this study was to determine the feasibility of a remifentanil/dexmedetomidine/neuraxial block technique in infants scheduled for surgery lasting longer than 2 hours.

A case report of multiple anesthesia for pediatric surgery: 80 anesthesia applications in a period of 6 years

The side and adverse effects of anesthesia and its neurotoxicity to children have become major concerns of anesthesiologists in recent years. Currently, no clinical trials have provided clear evidence indicating the suitable minimum age for a patient’s first anesthetic application, importance of anesthesia duration, number of anesthetic applications or interval between two consecutive anesthesia applications. A very rare case concerning the side, adverse and neurotoxic effects of multiple anesthesia in a child is presented.