Wednesday , January 27 2021

Anesthesia at the beginning of childhood not linked to development problems

By Lisa Rapaport

(Reuters Health) – Young children who underwent surgery under general anesthesia were not more likely than their brethren who were not exposed to anesthesia to experience development challenges that hamper school readiness, a Canadian study found.

Some previous studies suggest that the opposite could be true: that the developing brain could be injured by anesthesia drugs at the beginning of life, researchers point out at JAMA Pediatrics. But much of this research was based on studies in animals and laboratories, and not in children with surgery.

For the current study, researchers examined data about almost 11,000 pairs of siblings, including about 370 pairs with two brothers exposed to surgery under general anesthesia and approximately 2,350 pairs with only one brother with anesthesia exposure.

While children exposed to anesthesia seem to have a slightly greater risk of developing physical health problems or challenges in social, emotional or communication skills than their siblings who had no surgery, these differences were too small to rule out the possibility that they were Due to chance, once researchers have represented the age of children in surgery and other factors that can also affect development.

"The findings of the current study should reassure parents of young children who require anesthesia for surgical procedures," said lead author, Dr. James D. Leary, an anesthesiologist from the Sick Kids Hospital in Toronto and at the University of Toronto.

"However, the interpretation of the clinical implications of neurotoxicity related to anesthesia is a challenge and definitive clinical studies that provide high quality evidence on the relationship between exposure to anesthesia and neurological lesions are still required to guide treatment decisions," he said. said The Leary by email.

Most children who had surgery (about 60 percent) had at least two years of age at the time of their operations and most (almost 80 percent) did not have hospitalization at night.

The most common procedures include operations to solve problems with the ears, the mouth and the throat, the male genital organs or the musculoskeletal system.

In the parents with a brother who had surgery and one who did not do it, there was no difference in the proportion of children who had delays in language and cognitive development, social skills, emotional health and maturity, or communication skills.

The study included all eligible children for public or Catholic schools in Ontario, Canada, from 2004 to 2012.

The researchers examined data from a questionnaire that teachers completed to evaluate childhood development before children entered primary school when they were between five and six years old.

A disadvantage of the study is that it was not a controlled experiment designed to show if exposure to general anesthesia during surgery can directly affect brain development in childhood. Another limitation is the analysis that excludes the children with evaluations that point to possible problems of behavior, learning or development.

Parents of children who need surgery should still be reassured by the results, said Dr. Andrew Davidson of the Royal Children's Hospital and the Meldoch Children's Research Institute in Melbourne, Australia.

"This study adds to the growing data that, for the vast majority of cases, anesthesia does not have an impact on school preparation and this should add to the fact that we increasingly think in most cases has no impact on knowledge and many other aspects of neurodevelopment, "said Davidson, who was not involved in the study, by email.

But there are still some studies that link anesthesia to some behavioral problems, Davidson warned.

"Based on this study and others, parents whose children are healthy should not delay the necessary procedures that may require anesthesia," said Dr. Lena Sun, head of pediatric anesthesiology at the Morgan Stanley Children's Hospital and a specialist at the Columbia University Medical Center in New York City.

"However, research is still needed to identify subgroups of children who may be vulnerable to development for exposure to anesthesia," said Sun, who was not involved in the study, by email.

SOURCE: JAMA Pediatrics, online on November 5, 2018.

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