SmartTots update regarding anesthetic neurotoxicity in the developing brain

Beverley A. Orser, Santhanam Suresh, Alex S. Evers

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


SmartTots ( represents a public-private partnership between the International Anesthesia Research Society and the US Food and Drug Administration. Over the past 7 years, SmartTots has worked in collaboration with various stakeholders to determine whether anesthetic drugs have detrimental effects on the developing brain. SmartTots has funded clinical and preclinical studies, organized meetings, served as a repository of peerreviewed information, and facilitated the development of consensus-based statements. Here, we report advances in the field of anesthetic neurotoxicity and provide an update on SmartTots' activities. Clinical studies have provided some reassurance that a brief exposure to anesthetic drugs does not cause overt, persistent cognitive deficits. New recommendations aim to increase the reproducibility and "clinical relevance" of data from studies of laboratory animals. Overall, the field has advanced substantially; however, it remains paramount to definitively resolve whether anesthetic drugs are neurotoxic to the immature brain. The results of SmartTots efforts will either ally unwarranted fears or substantially change pediatric anesthetic practice and prompt studies to identify neuroprotective strategies.

Original languageEnglish
Pages (from-to)1393-1396
Number of pages4
JournalAnesthesia and analgesia
Issue number4
StatePublished - Apr 2018


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