Despite the profound evolution in the safety and efficacy of neonatal and pediatric anesthesia, questions remain concerning the long-term neurotoxic and neurocognitive effects of the drugs used in anesthetic care. A variety of prospective animal models and retrospective human studies exist that inconsistently demonstrate a detrimental effect of early life exposure to anesthetic drugs and subsequent learning performance. Limitations associated with both non-human and human observational studies are critiqued. Research currently underway is briefly described. A framework for discussing the relevant issues with concerned parents is presented.
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