Animal and in vitro studies – immediate neuroanatomical consequences and associated long-lasting (if not permanent) functional effects.

Clinical studies – single brief exposures reassuring. Long-term adverse neurodevelopment effects observed after prolonged or repeated anaesthesia (multiple confounders obviously).

Fetal exposure – no data.

December 2016, FDA issue “Drug Safety Communication” 

One Texas Children’s Hospital changed practice –  FDA warning now discussed with parents. Hospital now recommends discussion about duration of anaesthesia, plan for multiple general anaesthetics and possibility of delaying procedure until after 3 years of age.

No alternatives except dexmedetomidine and opioids but often not sufficient anaesthesia.

Prepare for the discussion!

Further reading:


(Click on the image above)