Developmental Anesthesia Neurotoxicity Research in Humans: Moving the Concept

( Anesthesiology . 2024;141(3):431–433. doi: 10.1097/ALN.0000000000005126) In this commentary on a recently published study by Silber and colleagues, Vutskits and Davidson discuss the impact of the findings on the field and topics for future investigations. There is much interest in anesthesia exposure and its impact on neurodevelopmental outcomes, with various observational studies previously investigating the link. Experts agree that the impact of anesthesia upon neurodevelopment is confounded by the concomitance of surgery. However, studies have failed to investigate the potential confounder of hospitalization on neurobehavioral outcomes. This big data observational study by Silber and colleagues, differs from previous studies due to the inclusion of healthy children as controls, and whether hospitalization itself impacts neurotoxicity and development, in a way previously attributed to either anesthesia exposure or surgery.