Anesthetic use in newborn infants: the urgent need for rigorous evaluation

Pediatric Research
Viviane G Nasr, Jonathan M Davis

Abstract

Approximately 1.5 million neonates receive general anesthesia each year for a surgical procedure. Despite this being an essential practice, a number of recent studies now indicate that anesthetic exposure could cause toxicity and neuronal apoptosis in the developing brain. This could potentially influence long-term neurodevelopmental outcome, especially premature infants in need of multiple surgical procedures. Most anesthetic drugs routinely administered to neonates have not been adequately tested for safety or efficacy. Given the number of confounders, dosing is often extrapolated from adults. This is concerning since many different drugs can be administered concurrently, with few of these agents actually approved for use by the Food and Drug Administration. Since 1997, legislation has been passed in the United States and abroad encouraging more drug investigation in infants and children. This has resulted in over 500 labeling changes to products regarding safety and efficacy in various pediatric age groups. However, only three drugs routinely used as anesthetic agents in newborn infants have had any updated labeling (none in very premature infants). This "off-label" use without adequate testing must be addressed. Therefore, ...Continue Reading

References

Aug 21, 2003·JAMA : the Journal of the American Medical Association·Rosemary RobertsTerrie Crescenzi
Aug 25, 2005·Clinical Therapeutics·K J S AnandGary A Walco
Aug 15, 2006·Drugs·Lars Welzing, Bernhard Roth
Sep 14, 2006·JAMA : the Journal of the American Medical Association·Daniel K BenjaminJennifer S Li
Oct 26, 2006·Clinical Therapeutics·Gerri R BaerUNKNOWN Ethics Group of the Newborn Drug Development Initiative
Feb 22, 2007·Anesthesia and Analgesia·R Daniel MellonBob A Rappaport
Mar 4, 2008·Pediatrics·William RodriguezRamana S Uppoor
Feb 6, 2009·Journal of Perinatology : Official Journal of the California Perinatal Association·K S HoehnR M Nelson
Dec 10, 2009·Archives of Pediatrics & Adolescent Medicine·Daniel K BenjaminJennifer S Li
Feb 19, 2010·The New England Journal of Medicine·Waldemar A CarloUNKNOWN First Breath Study Group
May 18, 2010·The New England Journal of Medicine·UNKNOWN SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research NetworkRosemary D Higgins
Dec 22, 2010·British Journal of Anaesthesia·L Sun
May 20, 2011·Journal of Perinatology : Official Journal of the California Perinatal Association·P S ShahUNKNOWN Canadian Neonatal Network
Jul 7, 2011·European Journal of Clinical Pharmacology·Kalle HoppuSaskia N de Wildt
Sep 17, 2011·Pharmacogenomics·Shinya Kasai, Kazutaka Ikeda
Oct 25, 2011·Anesthesia and Analgesia·James G Ramsay, Bob A Rappaport
May 23, 2012·Pediatrics·Jeffrey D HorbarJeffrey S Buzas
Oct 11, 2012·JAMA : the Journal of the American Medical Association·Jonathan M DavisAlastair J J Wood
May 2, 2013·JAMA : the Journal of the American Medical Association·Elisha M WachmanJonathan M Davis
Jun 7, 2013·The New England Journal of Medicine·Kathy L HudsonFrancis S Collins
Dec 11, 2013·JAMA Pediatrics·Matthew M LaughonWilliam Rodriguez
Feb 22, 2014·Advanced Drug Delivery Reviews·M A TurnerUNKNOWN Global Research in Paediatrics
Jun 18, 2014·JAMA Pediatrics·Robert WilliamsIan Black
Jun 18, 2014·JAMA Pediatrics·Frank H MorrissUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

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Citations

Nov 28, 2015·International Journal of Developmental Neuroscience : the Official Journal of the International Society for Developmental Neuroscience·Hongyan XiaoJun Zhang
Jun 17, 2016·Iranian Journal of Pediatrics·Nahid Ramazani
Oct 31, 2015·Journal of Paediatrics and Child Health·Eloisa GittoCarmelo Romeo
Jun 16, 2016·Journal of Pediatric Surgery·Matthieu Peycelon, Arnaud Bonnard
Jul 12, 2017·Expert Opinion on Drug Safety·Vincenzo FodaleAntonio David
Oct 27, 2015·Korean journal of anesthesiology·Si Ra Bang
Jul 25, 2017·Archives of Disease in Childhood. Fetal and Neonatal Edition·Rodney W HuntUNKNOWN Victorian Infant Collaborative Study group
Nov 15, 2016·European Journal of Anaesthesiology·E Noor BrinkmanJurgen C de Graaff
May 26, 2020·Minerva anestesiologica·Marta Somaini, Pablo Ingelmo
Nov 15, 2016·Frontiers in Neurology·Eran Elhaik
May 26, 2017·European Journal of Pediatrics·Pietro ImpellizzeriCarmelo Romeo
Mar 9, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Zhi JiaNing Xie
Jan 3, 2021·Pediatric Surgery International·Lindsey L WolfSamuel E Rice-Townsend
Sep 28, 2020·Lancet·Rebeccah SlaterAomesh Bhatt
Nov 16, 2021·TAG. Theoretical and applied genetics. Theoretische und angewandte Genetik·Rajiv SharmaIan J Mackay

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Methods Mentioned

BETA
sedation

Software Mentioned

PREA
BPCA
SmartTots

Related Concepts

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Apoptosis

Apoptosis is a specific process that leads to programmed cell death through the activation of an evolutionary conserved intracellular pathway leading to pathognomic cellular changes distinct from cellular necrosis