Current thinking regarding potential neurotoxicity of general anesthesia in infants

Mary Ellen McCann*, Jurgen De Graaff

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

14 Citations (Scopus)


Purpose of review: Numerous preclinical studies have shown that general anesthetics adversely influence the development of young brains. These adverse effects are dose-dependent occurring in specific stages of brain development. Histologic examinations show increased apoptosis, pathological neurogenesis and dendritic formation after exposure in infant animals to virtually all general anesthetics at a clinically effective dose which are associated with memory and behavioral changes at adulthood. Recent findings: Clinical research into the long-term effects of anesthesia during early childhood on brain development is mainly limited to retrospective cohort studies, with conflicting results. Only recently, the interim analysis of a prospective randomized clinical trial examining the effects of general anesthesia has been published. In this GAS-study the influence up to 1h of general anesthesia versus regional anesthesia in young infants has been assessed on the neurocognitive functioning at the age of 2 years. No differences were found between the two groups. However, the primary outcome analysis which is the 5-year outcomes will not be complete until 2018. Summary: Pending clear evidence, anesthesiologists should discuss the indication of anesthesia for surgery and diagnostic procedures with caregivers and parents taking into consideration the risks and benefits of the planned procedure.

Original languageEnglish
Pages (from-to)27-33
Number of pages7
JournalCurrent Opinion in Urology
Issue number1
Publication statusPublished - 2017

Bibliographical note

Publisher Copyright: Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.


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