Use of anaesthetics in young children: Consensus statement of the European Society of Anaesthesiology, the European Society for Paediatric Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology and the European Safe Tots Anaesthesia Research Initiative.

Experimental studies have shown that general anaesthetics may cause a variety of morphological changes in the developing immature brain of laboratory animals. In addition, there is some evidence that long-term and prolonged exposure may be worse than short-term exposure in some animal species. However, the relevance of these findings in human beings is currently unknown, and studies have shown controversial results. Although a number of investigations in humans have demonstrated an association between surgical and anaesthetic exposure and negative neurodevelopmental outcome, several others have been unable to find such an association or only in a minor subset of exposed children with or without extensive individual neurocognitive testing. It remains, therefore, very difficult to identify whether any negative neurodevelopmental effects are because of the anaesthetic drugs, the conduct of anaesthesia, surgical trauma or the underlying clinical conditions.