Anesthetic Exposure During Early Childhood and Neurodevelopmental Outcomes: Our Current Understanding

Purpose of Review The question of anesthetic neurotoxicity emerged two decades ago, but controversy about whether anesthetics cause neurodevelopmental problems in children remains. Interpretation of the published literature is complicated by a paucity of randomized controlled trials and heterogeneity of the published studies. This review summarizes our current understanding and discusses potential sources of study bias and methods to better understand and address issues contributing to bias. Recent Findings Recent clinical studies of anesthetic neurotoxicity and meta-analyses of the published studies have reported that children exposed to anesthesia have worse neurodevelopmental outcome scores than unexposed children, particularly in domains of executive function and behavior. Summary While anesthetic-exposed children report worse neurodevelopmental outcomes, whether these differences are caused by the anesthesia, or other factors such baseline disease, surgical inflammation, or physiologic disturbances, remains a subject of intense debate. To answer this question, further well-designed studies will be required.