Neonatal Anesthesia Neurotoxicity: A Review for Cleft and Craniofacial Surgeons

Area of Science:

• Neuroscience
• Anesthesiology
• Developmental Biology

Background:

• Growing evidence suggests anesthetic agents may cause damage to the developing brain.
• Animal studies provide compelling evidence for anesthetic neurotoxicity.
• Human research faces numerous confounders, hindering definitive risk conclusions.

Purpose of the Study:

• To review the evidence for anesthetic neurotoxicity in the developing brain.
• To discuss the implications of potential anesthetic risks for early surgical procedures.
• To prompt reevaluation of surgical timing and protocols in light of anesthetic risks.

Main Methods:

• Review of existing animal and human research on anesthetic effects on the brain.
• Analysis of confounders in human studies investigating anesthetic neurotoxicity.
• Risk-benefit assessment framework for early surgical interventions.

Main Results:

• Animal evidence strongly supports anesthetic neurotoxicity.
• Human studies are confounded, making risk quantification difficult.
• The risk of anesthetic neurotoxicity is currently unquantifiable.

Conclusions:

• The potential for anesthetic neurotoxicity in the developing brain requires careful consideration.
• The benefits of early surgery must be weighed against the unquantifiable risks of anesthetic agents.
• Surgical timing and protocols may need reevaluation to mitigate potential anesthetic risks.