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Acta Med Port. 2014 May-Jun;27(3):383-9. Epub 2014 Jun 30.

[Pediatric anesthetic during brain immaturity and neurodevelopment disorders].

[Article in Portuguese; Abstract available in Portuguese from the publisher]

Author information

Serviço de Anestesiologia. Centro Hospitalar Tondela-Viseu, EPE. Viseu. Portugal. Departamento de Cirurgia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.
Departamento de Cirurgia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal. Serviço de Cirurgia Pediátrica. Centro Hospitalar e Universitário de Coimbra, EPE. Coimbra. Portugal.
Serviço de Anatomia Patológica.. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.
Departamento de Anestesiologia/Cirurgia. Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal.


in English, Portuguese


Several experimental and clinical studies suggest that drugs used in pediatric anesthesia may exert undesirable effects on the developing central nervous system. The objective of this review was to assess the results and conclusions of published studies on long lasting neurodevelopment disorders following exposure to anesthetics in children in a phase of brain immaturity.


We performed a literature search in several sources (PubMed, SciELO and Cochrane Library) using the terms 'Pediatric anesthesia OR Pediatric anesthetic OR Developing brain anesthetic OR Developing brain anesthesia AND behavior disorders'. We selected human studies, referring to long lasting neurodevelopment effects after exposure to anesthetics in the first four years of life.


Ten retrospective studies met the inclusion criteria. Of these, seven suggest risk of neurobehavioral disorders after exposure of small children to anesthetics, as opposed to the results obtained by the other three.


Although mostly using large databases, the studies found are retrospective, vary in test groups, include sometimes avoidable confounders and some present inaccuracies in the choice of the test and control populations that can compromise the reliability of the results.


Because of the numerous limitations of the few studies available, the reported results are still deemed insufficient to change current clinical practice. However, although it is undisputable that anesthesia should be provided when needed, regardless of age, the warnings found in literature are worrisome, therefore whenever surgery is unavoidable in small children, alternatives that may help reduce the risks of anesthetic exposure should be sought.

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