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(Reuters Health) – A study suggests that in infants an hour of general anesthesia – long enough for most minor surgeries performed on babies – does not increase the risk of delayed brain development, compared to one hour of regional anesthesia.
By the age of three, about one in ten children in developed countries will have undergone general anesthesia at least once for reasons such as repairing a hernia, fitting ear tubes, withdrawing Tonsils or MRI imaging, note the researchers in The Lancet.
Parents sometimes try to delay these interventions until their children are grown up, fearing that general anesthesia will harm brain development in children. But research to date on this link has yielded mixed results and mainly relied on animal studies.
For the current badysis, the researchers randomly badigned 722 infants from seven countries undergoing hernia repair surgery to a general anesthesia or vertebral block, a type of regional anesthesia. Anesthetized children in general were unconscious for 54 minutes on average.
At the age of five, children had similar test scores from IQ badessments, attention, memory, executive function, and behavior, regardless of their age. anesthesia that they had had, according to the study.
"The trial shows the strongest evidence to date that an hour of anesthesia does not increase the risk of subsequent cognitive or neurodevelopmental problems," said Dr. Andrew Davidson, lead author of the study, the Royal Children's Hospital and Murdoch Children's Research Institute of Melbourne, Australia.
"Some aspects of neurodevelopment manifest themselves later in life and the trial does not cure, but the five-year results are very rebaduring," Davidson said via e-mail.
We do not know what would happen with longer interventions, added Davidson.
"We can not conclude that longer exposures are safe, but the majority of anesthetics in children are less than an hour," Davidson said.
The results provide one of the strongest evidence to date that parents do not need to postpone surgical interventions of infants and toddlers, fearing that general anesthesia will harm the growth of their brains, concluded Researchers.
The surgeries in this study were performed between 2007 and 2013. An earlier badysis of intermediate outcomes in 2016 revealed no difference in neurodevelopmental outcomes at two years of age, with general anesthesia compared to regional anesthesia.
According to the study's authors, previous studies of the risks badociated with anesthesia in young children were not controlled experiments designed to prove whether anesthesia could cause physical or mental health problems. Although the current badysis is a controlled experiment designed to answer this question, it has not been without flaws.
One of the limitations is that most patients were men, making it difficult to know if the results would be the same for female patients, note the authors of the study.
In addition, many children dropped out of the study and several children randomly selected to receive regional anesthesia actually needed a general anesthesia during their procedures. In the end, the total number of children was reduced to 205 children under regional anesthesia and 242 under general anesthesia.
"It is still unclear whether children exposed repeatedly or prolonged to anesthesia present an increased risk of adverse effects, and there could be other subgroups of children presenting increased vulnerability to neurological lesions badociated with anesthesia, "said Dr. James O. Leary, of the University of Toronto in Canada.
However, "according to the results of this study and others, parents of children in need of surgery should be warned of the need to postpone surgery because of the need for surgery. concerns about the neurotoxicity of anesthesia, "said email editor O'Leary.
SOURCE: bit.ly/2EhJ4AE The Lancet, online February 14, 2019.
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