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Br J Anaesth. 2017 Sep 1;119(3):458-464. doi: 10.1093/bja/aex141.

What do recent human studies tell us about the association between anaesthesia in young children and neurodevelopmental outcomes?

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Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Department of Anaesthesia, University of Toronto, 12th Floor, 123 Edward Street, Toronto, Ontario M5G 1E2, Canada.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, 200?1ST ST SW, Rochester, MN 55905, USA.


Anaesthetic and sedative drugs transiently disrupt normal neural activity to facilitate healthcare procedures in children, but they can also cause long-term brain injury in experimental animal models. The US Food and Drug Administration (FDA) has recently advised that repeated or lengthy exposures to anaesthetic and sedative drugs prior to 3 yr of age have the potential to harm the development of children's brains and added warnings to these drug labels. Paediatric anaesthesia toxicity could represent a significant public health issue, and concern about this potential injury in children has become an important issue for families, paediatric clinicians and healthcare regulators. Since late 2015, important new data from five major clinical studies have been published. This narrative review aims to provide a brief overview of the preclinical and clinical literature, including a comprehensive review of these recent additions to the human literature. We integrate these new data with prior studies to provide further insights into how these clinical findings can be applied to children.


anaesthesia neurotoxicity; neurodevelopment; paediatric surgery

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