Paediatric anaesthesia practise is changing. This change is primarily the result of new evidence emerging from analyses of large datasets and represents a shift in focus from prevention of perioperative mortality towards a reduction of perioperative morbidity. Children do offer the unique opportunity to study the lifelong consequences of any early intervention. The effects of early-life surgical and anaesthetic exposure may resonate through adolescence and into adulthood. Therefore, it appears necessary to perform long-term follow-up over several years until higher cognitive and other physiological functions have been fully matured and developed.