Anesthetics and the developing brain.

In the past decade, concern has been raised about the safety of anesthetic agents on the developing brain. Animal studies have shown an increase in apoptosis in the developing brain when exposed to N-methyl-D-asparate receptor blockers and/or gamma-aminobutyric acid receptor agonists that is related to the dose and duration of anesthetic agents. Whether these studies can be extrapolated to humans is being investigated. The Food and Drug Administration in 2007 convened an advisory committee to look at this issue. They found that the animal data available were inadequate to extrapolate to humans and determined that human studies were necessary. Human studies are underway but the challenge they face is how to delineate the effects of anesthesia from those of the underlying medical condition and surgery itself. At this time, we must continue to make decisions based on the known risks and benefits of anesthetics and apply it on an individual basis.