Dean B. Andropoulos, MD, and Michael Greene, MD, penned a column for the New England Journal of Medicine debating the implications of general anesthesia use in patients under three years old and in pregnant women in the third trimester.
Following intense discussion over anesthesia's long term effects on the developing brain, the FDA issued a communication on Dec. 14, 2016, warning about the use of general anesthesia and sedation for children less than 3-years-old and pregnant women in the third trimester.
The FDA warned for those patients, undergoing anesthesia for three hours or through repeated use "may affect the development of children's brains."
The warning resulted in labeling changes for 11 common general anesthetics and for sedative agents that bind to gamma-aminobutyric acid or N-methyl-D-aspartate receptors.
The authors argue the warning is hazardous because it could encourage parents and pregnant women to delay "necessary surgical and diagnostic procedures that require anesthesia, resulting in adverse outcomes for parents, patients and physicians to carefully consider the risks of delaying indicated procedures."
The authors advocate for continued research into the effects of repeated and prolonged anesthesia use in children.