Response to FDA’s Anesthesia Warning on Developing Brains
This expert opinion by Andropoulos and Greene (NEJM, 2017) briefly reviews studies about anesthesia in developing brains and responds to the FDA’s recent guidelines on administering anesthesia in young patients.
This article discusses the implications of the FDA’s recent recommendation to not administer anesthesia to children under the age of three nor to pregnant mothers for fear of adversely impacting the children’s developing brains. While studies in animal models have shown that anesthesia can impact neural development, so far no clinical studies have shown the same. One reason the data is unclear is that many young children undergoing surgery have serious health problems, and any issues with neural development may be a symptom of that as opposed to exposure to anesthesia.
This expert opinion warns against delaying surgery until after the age of three, because this could have significant ramifications on a child’s health, and recommends that doctors, surgeons, and parents discuss individual cases. This paper is consistent with the ACOG response which noted the absence of data in the prenatal setting and likewise encourages clinical judgement in the use of sedation and anesthesia and the importance of not delaying necessary surgeries.
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