Early childhood general anaesthesia exposure and neurocognitive development

A great deal of concern has recently arisen regarding the safety of anaesthesia in infants and children. There is mounting and convincing preclinical evidence in rodents and non-human primates that anaesthetics in common clinical use are neurotoxic to the developing brain in vitro and cause long-ter...

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Bibliographic Details
Published in:	British journal of anaesthesia : BJA 2010-12, Vol.105 (suppl-1), p.i61-i68
Main Author:	Sun, L
Format:	Article
Language:	eng
Subjects:	anaesthesia anaesthesia, paediatric Anesthesia, General - adverse effects Anesthetics, General - adverse effects Animals Brain - drug effects Brain - growth & development Child Child, Preschool children Cognition Disorders - chemically induced Developmental Disabilities - chemically induced Disease Models, Animal Evidence-Based Medicine - methods Humans Infant neurocognitive outcome neurotoxicity paediatric Paediatrics Primates risk
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Summary:	A great deal of concern has recently arisen regarding the safety of anaesthesia in infants and children. There is mounting and convincing preclinical evidence in rodents and non-human primates that anaesthetics in common clinical use are neurotoxic to the developing brain in vitro and cause long-term neurobehavioural abnormalities in vivo. An estimated 6 million children (including 1.5 million infants) undergo surgery and anaesthesia each year in the USA alone, so the clinical relevance of anaesthetic neurotoxicity is an urgent matter of public health. Clinical studies that have been conducted on the long-term neurodevelopmental effects of anaesthetic agents in infants and children are retrospective analyses of existing data. Two large-scale clinical studies are currently underway to further address this issue. The PANDA study is a large-scale, multisite, ambi-directional sibling-matched cohort study in the USA. The aim of this study is to examine the neurodevelopmental effects of exposure to general anaesthesia during inguinal hernia surgery before 36 months of age. Another large-scale study is the GAS study, which will compare the neurodevelopmental outcome between two anaesthetic techniques, general sevoflurane anaesthesia and regional anaesthesia, in infants undergoing inguinal hernia repair. These study results should contribute significant information related to anaesthetic neurotoxicity in children.
ISSN:	0007-0912 1471-6771