Editorial Views  |   April 2018
The Challenges of Translation
Author Notes
  • From the Department of Anesthesiology and the Department of Biochemistry and Molecular Biophysics, Washington University in St. Louis, St. Louis, Missouri; and the Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University in St. Louis, St. Louis, Missouri.
  • Corresponding articles on pages 697, 700, 832, and 840.
    Corresponding articles on pages 697, 700, 832, and 840.×
  • Accepted for publication January 5, 2018.
    Accepted for publication January 5, 2018.×
  • Address correspondence to Dr. Kharasch: editor-in-chief@asahq.org
Article Information
Editorial Views / Central and Peripheral Nervous Systems / Pediatric Anesthesia
Editorial Views   |   April 2018
The Challenges of Translation
Anesthesiology 4 2018, Vol.128, 693-696. doi:10.1097/ALN.0000000000002122
Anesthesiology 4 2018, Vol.128, 693-696. doi:10.1097/ALN.0000000000002122
FOR decades, the question of neonatal anesthetic toxicity has variably met with passionate concern, perplexity, or indifference among the anesthesia practitioner and investigator communities. What began as a laboratory observation and academic curiosity of unknown clinical relevance, leading to clinical research and clinical concern, was elevated to a real clinical predicament by an unexpected 2016 U.S. Food and Drug Administration (FDA) Safety Announcement1  declaring that “repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children’s brains,” with admonitions to healthcare professionals, parents, pregnant women, and caregivers. This was followed in 2017 by FDA–approved formalized changes to several drug labels to memorialize this warning.2  The aftermath has seen heightened consternation and confusion, with variable response among parents, practitioners, regulators, anesthesiology societies, healthcare institutions, and their risk managers, as well as changes (or not) in informed consent, and several position statements and commentaries.3–5  Having allowed this initial flurry to subside, Anesthesiology this month features two comprehensive review articles6,7  and accompanying editorials8,9  on anesthetic developmental neurotoxicity in animals and in humans.
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