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Newly Postulated Neurodevelopmental Risks of Pediatric Anesthesia

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Abstract

Recent animal and human studies have raised concern that exposure to anesthetic agents in children may cause neuronal damage and be associated with adverse neurodevelopmental outcomes. Exposure of young animals to anesthetic agents above threshold doses and durations during a critical neurodevelopmental window in the absence of concomitant painful stimuli causes widespread neuronal apoptosis and subsequent abnormal behaviors. The relevance of such animal data to humans is unknown. Untreated neonatal pain and stress also are associated with enhanced neuronal death and subsequent maladaptive behaviors, which can be prevented by exposure to these same anesthetic agents. Retrospective observational human studies have suggested a dose-dependent association between multiple anesthetic exposures in early childhood and subsequent learning disability, the causality of which is unknown. Ongoing prospective investigations are underway, the results of which may clarify if and what neurodevelopmental risks are associated with pediatric anesthesia. No change in current practice is yet indicated.

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Authors and Affiliations

  1. Departments of Anesthesiology & Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA

    Stephen R. Hays

  2. Division of Pediatric Anesthesia, Monroe Carell Jr. Children’s Hospital at Vanderbilt, 2200 Children’s Way # 3115, Nashville, TN, 37232-9070, USA

    Stephen R. Hays

  3. Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Jayant K. Deshpande

  4. Department of Anesthesiology, Arkansas Children’s Hospital, 1 Children’s Way, Little Rock, AR, 72202-3591, USA

    Jayant K. Deshpande

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  1. Stephen R. Hays
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  2. Jayant K. Deshpande
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Correspondence to Stephen R. Hays.

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Hays, S.R., Deshpande, J.K. Newly Postulated Neurodevelopmental Risks of Pediatric Anesthesia. Curr Neurol Neurosci Rep 11, 205–210 (2011). https://doi.org/10.1007/s11910-010-0177-4

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  • DOI: https://doi.org/10.1007/s11910-010-0177-4

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