Controversies in anesthesia-induced developmental neurotoxicity

Abstract

Advances in the field of pediatric anesthesiology have enabled the performance of complex and life-saving procedures with minimal patient discomfort. However, preclinical studies over the past two decades have been reporting substantial neurotoxic potential of general anesthetics in young brain, thus challenging the safety of these agents in pediatric anesthesiology practice. Notwithstanding the overwhelming preclinical evidence, the translatability of these findings has proven inconsistent in human observational studies. The significant degree of anxiety and apprehension surrounding the uncertainty of long-term developmental outcomes following early exposure to anesthesia has prompted numerous studies around the world to investigate the putative mechanisms and translatability of preclinical findings regarding anesthesia-induced developmental neurotoxicity. Guided by the vast preclinical evidence, we aim to highlight relevant human findings presented in the currently available clinical literature.

Keywords: ADHD; ASD; anesthesia neurotoxicity; behavior; clinical trials; cognitive development; immature brain; neuroapoptosis.