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

  • Anesthesia, Pain Management and Long-term Outcomes (VNR Gottumukkala and ER Mariano, Section Editors)
  • Published:
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Abstract

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.

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Authors and Affiliations

  1. Department of Anesthesiology, Columbia University College of Physicians and Surgeons, 622 W. 168Th St., BHN 4-440, New York, NY, 10032, USA

    Tanvee Singh & Caleb Ing

  2. Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA

    Amy Pitts & Caleb Miles

  3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Caleb Ing

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T.S. and C.I. wrote the main manuscript text. A.P. and C.M. also contributed to writing and editing the manuscript. A.P. prepared Figure 1. All authors reviewed the manuscript.

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Correspondence to Caleb Ing.

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Conflict of Interest and Financial Disclosure Statement

CI and CM are supported by the Agency for Healthcare Research and Quality (AHRQ) under award number R01HS026493. AP is supported by the National Institute on Drug Abuse (NIDA) under award number T32DA031099. The content is solely the responsibility of the author and does not necessarily represent the official views of the AHRQ or NIDA. There are no commercial associations, or any other conditions posing a conflict of interest to report for any of the above authors.

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Singh, T., Pitts, A., Miles, C. et al. Anesthetic Exposure During Early Childhood and Neurodevelopmental Outcomes: Our Current Understanding. Curr Anesthesiol Rep 14, 15–24 (2024). https://doi.org/10.1007/s40140-023-00592-y

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