Commentary
A prospective randomized clinical trial evaluated neurodevelopmental outcomes in children younger than two years of age undergoing surgery with sevoflurane-based general anesthesia. Investigators compared standard sevoflurane anesthesia with techniques designed to reduce sevoflurane exposure and found no measurable differences in cognitive, behavioral, or language outcomes at follow-up. The study adds to previous large clinical trials indicating that a single brief exposure to inhaled anesthesia in otherwise healthy children has not been associated with clinically significant neurodevelopmental deficits. Concerns about anesthetic neurotoxicity have been a major topic of research and regulatory attention for more than a decade, and ongoing clinical evidence is important for guiding both clinical decision-making and future anesthetic development.