title: Update on developmental anesthesia neurotoxicity.
abstract: OBJECTIVE
  Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field.
  
  
  RESULTS
  Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions that are translationally relevant to human clinical practice. Converging evidence from rodent experiments strongly suggest that anesthetics exert developmental stage-dependent and context-dependent impact on developing neuronal circuitry and, therefore, may induce lasting changes in neuronal plasticity. Although three recent population-based human studies found a strong evidence for small increase in risk, the two most robust studies (General Anaesthesia compared to Spinal anaesthesia trial and Pediatric Anesthesia Neurodevelopment Assessment) did not find an association between brief anesthesia exposure and poor neurodevelopmental outcome.
  
  
  CONCLUSIONS
  Experimental data with reasonable translational relevance suggest that early-life exposure to general anesthetics can induce lasting behavioral and cognitive deficits. In contrast, human studies provide, at best, mixed evidence about developmental anesthesia neurotoxicity. Future research, both experimental and human, is needed to clarify this important issue.
authors.affiliation: aDepartment of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva bDepartment of Basic Neurosciences, University of Geneva Medical School, Geneva, Switzerland cDepartment of Anaesthesia, Royal Children's Hospital dMelbourne Children's Trials Centre, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Vutskits
authors.forename: Andrew
authors.initials: A
authors.lastname: Davidson
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects*; D000818:Animals; D001921:Brain / Q000187:drug effects* / Q000254:growth & development; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002657:Child Development / Q000187:drug effects; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D020258:Neurotoxicity Syndromes / Q000453:epidemiology / Q000209:etiology*; D011323:Primates
chemical_list: D000777:Anesthetics