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Anesthetic neurotoxicity--clinical implications of animal models

Bob A Rappaport1, Santhanam Suresh, Sharon Hertz

  • 1From the Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD (B.A.R., S.H.); Northwestern University Feinberg School of Medicine, Chicago (S.S.); Washington University School of Medicine, St. Louis (A.S.E.); and the Department of Anesthesia and Physiology, University of Toronto, Toronto (B.A.O.).

The New England Journal of Medicine
|February 26, 2015
PubMed

Insights

Anesthetics and sedatives may cause neurotoxicity in young children, according to animal studies. The FDA SmartTots initiative advises large clinical studies and delaying nonurgent anesthesia in children under three.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Pediatric Medicine

Background:

  • Emerging evidence suggests potential neurotoxic effects of certain anesthetics and sedatives.
  • Animal models indicate risks associated with anesthetic exposure in developing brains.

Purpose of the Study:

  • To review the current understanding of anesthetic neurotoxicity in young children.
  • To inform clinical practice guidelines regarding anesthesia in pediatric populations.

Main Methods:

  • Review of existing animal study data on anesthetic neurotoxicity.
  • Analysis of recommendations from regulatory bodies and expert collaborations like SmartTots.

Main Results:

  • Laboratory animal studies indicate that some anesthetics and sedatives can lead to neurotoxic outcomes.
  • These findings raise concerns about the safety of anesthetic agents in vulnerable pediatric populations.

Conclusions:

  • The FDA collaboration SmartTots recommends further large-scale clinical studies to confirm these risks in humans.
  • A precautionary approach is advised, suggesting the avoidance of nonurgent surgical procedures requiring anesthesia in children under three years of age.

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