General anesthetics and neurotoxicity in the developing brain: A review of current literature

The question that general anesthetics (both inhaled and intravenous) might be neurotoxic for the developing brain has been asked for more than two decades, following an extensive number of animal studies. Nevertheless, the same effect on human developing brain was mostly ignored on the basis of difficulty with direct application of animal data to humans. Recently, two epidemiological studies showed an association between learning disabilities and anesthesia during the first years of life, suggesting that general anesthetics could potentially be harmful. Human, prospective, randomized trials are underway to try and clarify this issue, but their results will be available only 5-6 years from now. In this article, we are presenting a review of the rapidly growing scientific evidence for anesthesiainduced neurodegeneration and its implications for pediatric anesthesia.