November 2014


FDA Science Board Review: November 19

On November 19, 2014, the FDA Science Board will review the existing nonclinical and clinical data related to the use and potential toxicity of anesthetics and sedation drugs in the pediatric population. 

Consensus Statement and Revision

In December 2012, SmartTots released a Consensus Statement on the Use of Anesthetics and Sedatives in Children to provide guidance to healthcare providers and parents with regard to research findings that suggest anesthetics may be harmful to the developing brain. Consideration of the emerging evidence has prompted a revision of the 2012 statement.  Read more

Research News & Updates

Neurosurgical conditions and procedures in infancy are associated with mortality and academic performances in adolescence: a nationwide cohort study

Neurosurgery in infancy was associated with high mortality and significantly impaired academic achievements in adolescence. When studying anesthesia-related neurotoxicity and the developing brain, pooling of major/minor conditions and major/minor surgeries should be avoided.  Read more

Do we actually need to anesthetize the neonate?

Recurring themes are that neonatal physiology is substantially different from older children, that there are substantial gaps in our understanding of basic pharmacology and physiology, and there is a relative paucity of strong clinical evidence to guide practice.  Read more

Report of the Fourth PANDA Symposium on Anesthesia and Neurodevelopment in Children

The PANDA symposium has become a platform to review current preclinical and clinical data related to anesthetic neurotoxicity, to discuss relevant considerations in study design and approaches to future research among clinicians and researchers, and finally to engage key stakeholders in this controversial public health topic.  Read more

Clinical Research Into Anesthetic Neurotoxicity: Does Anesthesia Cause Neurological Abnormalities in Humans?

Additional preclinical and clinical research efforts are urgently required to address the effects of anesthetic exposure in human brain development.  Read more

Review: effects of anesthetics on brain circuit formation

There is evidence that anesthetics can disrupt brain circuit formation, including effects on neuronal survival and neurogenesis, neurite growth and guidance, formation of synapses, and function of supporting cells.  Read more

Isoflurane Impairs the Capacity of Astrocytes to Support Neuronal Development in a Mouse Dissociated Coculture Model

Isoflurane interferes with the ability of cultured astrocytes to support neuronal growth. This finding represents a potentially novel mechanism through which general anesthetics may interfere with brain development.  Read more

Postoperative Cognitive Function Following General Versus Regional Anesthesia: A Systematic Review

Sixteen studies were included in the final analysis. Three studies showed some difference in cognitive function between regional and general anesthesia, whereas the remaining 13 showed no difference between regional and general anesthesia on postoperative cognitive function.  Read more

Neurodevelopmental Outcomes After Initial Childhood Anesthetic Exposure Between Ages 3 and 10 Years

Decreased motor function was found in children initially exposed after age 3 even after accounting for comorbid illness and injury history.  Read more

Engaging Stakeholders in Research Related to Anesthesia and Neurodevelopment in Children

Clinicians and researchers need to adopt strategies to engage and partner with stakeholders as co-investigators who actively participate in efforts to increase anesthetic safety in children.  Read more

Pediatric Surgeons and Anesthesiologists Expand the Dialogue on the Neurotoxicity Question, Rationale for Early and Delayed Surgeries, and Practice Changes While Awaiting Definitive Evidence

The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risksRead more

Anesthesia in Children: Perspectives From Nonsurgical Pediatric Specialists

Given recent publications suggesting the potential for neurotoxicity following anesthesia in pediatric patients, physicians, parents, and other stakeholders are now challenged to continue to balance safety with efficacy in caring for children.  Read more