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!
(Click on the image above)