Long-Term Effects of Pediatric Procedural Sedation: Neurotoxicity and Neurocognitive Outcomes.

There is growing concern regarding potential neurotoxicity and long-term neuro-cognitive outcomes in young children receiving general anesthetics (GAs) and sedatives. Most currently used anesthetics and sedatives have shown to be potentially neurotoxic in animal studies. However, three landmark human studies have provided compelling evidence that a single brief exposure to GAs at an early age does not affect neurocognitive or behavioral outcomes. It is unclear if multiple exposures to GAs and sedatives in early childhood lead to worse neurocognitive or behavioral outcomes. This review article will summarize the evidence in both animal and human studies and discuss the limitations in both. Furthermore, we will suggest strategies to limit GA and sedative exposure in young children, as well as propose future directions of study.