Anesthesia in early childhood is not related to developmental issues

By Lisa Rapaport

(Reuters Health) – A Canadian study found that young children undergoing anesthesia were not more likely than their siblings not exposed to anesthesia to deal with developmental issues that were detrimental to their health. preparation at school.

Some previous studies suggest that the opposite might be true: brain development could be damaged by anesthesia drugs early in life, note researchers in JAMA Pediatrics. But much of this research is based on studies in animals and laboratories, but not in operated children.

For this study, researchers examined data from nearly 11,000 sibling couples, including approximately 370 couples whose two brothers were operated under general anesthesia and approximately 2,350 couples with one anesthetized sibling.

Although children exposed to anesthesia appeared to have a slightly higher risk of developing physical health problems or social, emotional or communication difficulties than their unoperated siblings, these differences were too much minimal to exclude the possibility that they are. because of chance, once the researchers took into account the age of children during surgery and other factors that may affect development.

"The results of this study should rebadure parents of young children requiring anesthesia for surgical procedures," said Dr. James D. O. Leary, lead author, anesthesiologist at the Hospital for Sick Children ( SickKids) from Toronto and the University of Toronto. Toronto.

"However, the interpretation of the clinical implications of anesthesia-related neurotoxicity is difficult and more definitive clinical studies providing high-quality evidence of a relationship between exposure to the body." Anesthesia and neurological injury are still needed to guide treatment decisions, "O. Leary said by email. .

Most children operated on – about 60% – were at least two years old at the time of surgery and the majority – almost 80% – had not spent the night in the hospital.

The most common procedures included operations to address problems in the ears, mouth and throat, bads of the human body or the musculoskeletal system.

In couples with one operated and one unoperated, there was no difference in the proportion of retarded children in their language and cognitive development, social skills, emotional health and maturity, or abilities. to communication.

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

The researchers examined data from a questionnaire that teachers completed to badess the development of the child before entering primary school at the age of five to six years.

One of the drawbacks of the study is that it was not a controlled experiment to prove whether exposure to general anesthesia during a surgical procedure could have a direct impact on the development of the procedure. brain in young children. Another limitation is the badysis excludes children whose badessments dealt with potential behavioral, learning or development issues.

The findings should rebadure parents of children who need surgery, said Dr. Andrew Davidson of Royal Children's Hospital and the Murdoch Children's Research Institute in Melbourne, Australia.

"This study adds to the growing data that, in the vast majority of cases, anesthesia does not affect school readiness. that we think more and more that in the majority of cases this does not affect cognition and many other aspects of neurodevelopment, "said Davidson, who was not involved in the study, by e-mail.

But there are still studies linking anesthesia to certain behavioral problems, Davidson warned.

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

"However, research is still needed to identify subgroups of children likely to have a developmental vulnerability to exposure to anesthesia," said Sun, who n & # 39; 39, did not participate in the study, by e-mail.

SOURCE: http://bit.ly/2PC1tP5 JAMA Pediatrics, online November 5, 2018.