[Is anaesthesia detrimental to brain development?]

Many experimental studies in mammals, and increasingly also in primates, have shown that almost all anaesthetic agents when administered during a young animal's brain-development phase cause increased neuroapoptosis and changes in dendritic morphology at short term, and later, learning disorders. These findings are being confirmed in increasing numbers of retrospective cohort studies in humans. However, these retrospective cohort studies are considerably influenced by confounding. A current prospective randomized clinical trial comparing general and locoregional (spinal) anaesthesia for hernia repair could provide some clinical evidence. These study results will only provide information on relatively short procedures and will not be available until the first reliable neuropsychological evaluation at age 5 in 2018. Pending this additional data, we should discuss with our surgical colleagues the indications, timing and duration of surgery and - if possible - postpone elective surgery until the child is more mature.