A New Look at General Anesthesia and the Developing Brain

The developmental risk associated with exposure to general anesthesia in young children is largely unknown. In an editorial from the FDA published in the New England Journal of Medicine, the authors describe a growing body of evidence suggesting that the developing brain is uniquely vulnerable to anesthetic agents, particularly NmethylDaspartate (NMDA) receptor antagonists (e.g., ketamine) and γaminobutyric acid (GABA) agonists (e.g., isoflurane). Studies in rodents and nonhuman primates indicate that prolonged exposure to these anesthetic agents during specific windows of neurodevelopment result in widespread neuronal cell death and long-term cognitive deficits.

Two retrospective cohort studies suggest that the risk associated with exposure…