No Adverse Neurodevelopmental Effects Seen From Inhaled Anesthesia in Children Under 2

THURSDAY, Sept. 11, 2025 (HealthDay News) — For children younger than 2 years undergoing surgery, no adverse neurodevelopmental effects are seen with the addition of dexmedetomidine and remifentanil to sevoflurane anesthesia versus sevoflurane alone, according to a study published online Sept. 9 in Anesthesiology.

Sang-Hwan Ji, M.D., Ph.D., from Seoul National University Hospital in the Republic of Korea, and colleagues conducted a prospective, double-blind, randomized clinical trial including children younger than 2 years undergoing nonstaged, nonrepetitive surgeries to examine whether the combination of dexmedetomidine and remifentanil had any differential effect on neurodevelopmental outcomes compared to sevoflurane alone. Participants received dexmedetomidine and remifentanil as adjuncts to sevoflurane (DEX-R group; 176 children) or sevoflurane alone (control group; 169 children). Using the Korean Leiter International Performance Scale and the Child Behavior Checklist, neurodevelopmental status was examined at 28 to 30 months.

The researchers found that the groups had no difference in the mean anesthesia duration. Compared with the control group, the DEX-R group had a significantly lower mean end-tidal sevoflurane concentration (1.8 versus 2.6 percent; P < 0.001). The mean full-scale IQ score was 102.5 ± 11.5 and 103.6 ± 11.5 in the DEX-R and control groups, respectively (P = 0.442). The Child Behavior Checklist total score did not differ significantly between the groups.

“These findings support existing evidence suggesting that brief anesthetic exposure is unlikely to result in clinically significant neurodevelopmental impairment,” the authors write.

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