New Study Finds No Evidence of Neurotoxicity from Inhaled Anesthesia in Young Children

A recent clinical trial has provided reassuring evidence that brief exposure to inhaled anesthesia during surgery does not result in neurodevelopmental harm in infants and young children. Published in the journal Anesthesiology, the study examined neurodevelopmental outcomes in children under two years of age who underwent surgery with anesthesia involving sevoflurane, a commonly used inhaled anesthetic.

The researchers, led by Dr. Ji-Hyun Lee from Seoul National University Hospital, employed a 'balanced' anesthesia strategy that used a lower dose of sevoflurane combined with intravenous sedatives and opioids. This approach aimed to reduce the amount of inhaled anesthetic required during surgery, which lasted less than 90 minutes for all participants. About 400 children participated in the study, which was designed to evaluate whether reducing sevoflurane dosage could lower any potential neurotoxic risk.

When the children reached approximately 30 months old, their neurodevelopment was assessed through nonverbal intelligence tests and parent-reported behavior scales. The primary finding revealed no significant differences in overall IQ, language development, or behavioral outcomes between children who received the lower dose of sevoflurane and those who had the standard approach. The results suggest that brief anesthetic exposure, even at typical doses, is unlikely to cause lasting neurodevelopmental issues.

These findings are especially important given previous animal studies that raised concerns about the neurotoxic effects of general anesthetics in young brains. In response, the U.S. Food and Drug Administration issued warnings in 2017 about potential risks associated with prolonged or repeated exposure to such drugs in children under three years old. However, current evidence from clinical trials, including this recent study, indicates that a single, brief exposure during surgery may be safe.

The study's authors emphasize that their results are preliminary, and ongoing long-term follow-up will be critical to confirm these findings as children grow older. Meanwhile, the study provides a measure of reassurance for parents and medical professionals regarding the neurodevelopmental safety of anesthesia in early childhood.

Expert commentary by Drs. Andrew Davidson and Caleb Ing highlighted the importance of this research in filling a significant knowledge gap. They noted that studying neurodevelopmental outcomes in children undergoing surgery is complex, due to confounding factors such as underlying health issues. Nonetheless, the current evidence supports the safety of inhaled anesthesia for young children when used appropriately.

In summary, this new research suggests that brief exposure to inhaled sevoflurane during surgery does not adversely impact neurodevelopmental outcomes in early childhood, offering reassurance to parents and healthcare providers. Further long-term studies are anticipated to solidify these findings.

Source: https://medicalxpress.com/news/2025-09-toxic-effects-inhaled-anesthesia-young.html