1 Answers
The effects of early-life exposures to anesthesia on the brain in humans are controversial. Evidence from nonhuman primate research suggests significant developmental neurotoxicity and long-term social impairment, with a dose–response relationship where repeated exposures cause a more severe impact than single ones. Research in humans has not found conclusive clinical evidence of cognitive impairment; however, systematic reviews imply the possibility of greater behavioural impairments in children exposed to anesthesia before the age of three than control subjects.
Debate exists over the real-world consequences of these impacts. The effect size of early-life anesthesia exposure appears small, and may or may not be practically relevant. In 2016, the United States Food and Drug Administration issued a communication cautioning about "repeated or lengthy" exposure to general anesthetic prior to age three and suggested clinicians and caregivers weigh the risks and benefits of surgical procedures longer than three hours in this population.