Babies under general anesthesia will not affect their development, says new study

Making the decision to operate a baby or toddler can be complex and challenging for parents. This involves weighing the risks against the expected benefits for the child.

One of the issues that influenced the decision has always been whether general anesthesia is safe for the vulnerable and rapidly developing brains.

Parents in this situation may be rebadured after a new study published in The Lancet this week showed that a single episode of general anesthesia in the infant had no detectable impact on the subsequent development of the brain.

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Why worry?

In the United States, the Food and Drug Administration has been cautious since 2007, after studies showing that some of the gases used in general anesthesia appeared to have permanent negative effects on brain development in rats and monkeys. .

Research has been planned and funded to address this issue by examining evidence in the real world. After all, human brains are not the same as rat brains.

Studies that have been performed in humans have been observatory (retrospective). It is therefore difficult to differentiate the effect of anesthesia from the effects of the condition for which the operation was performed or other factors affecting the child.

What does this study propose?

The strengths of the study are important. First, it was a large project involving 722 participants from children's hospitals in seven countries, including Australia.

It was also well designed. In particular, it was a prospective (prospective) study with a design allowing researchers to clearly discern the isolated effect of anesthesia.

This was done by comparing the same procedure performed for the same reason using anesthesia of the spine, where the patient is numb in the field of surgery but awake, or a conventional general anesthesia where the patient is unconscious.

The procedure chosen for the study was to repair a herniated groin, a condition characterized by the protrusion of the internal tissues of the abdomen by a weak point of the abdominal muscle. Most people who undergo the operation are performing well and have a low complication rate. It is also practiced in children generally in good health.

This surgical procedure is generally performed during the first two months of a child's life to prevent abnormal development of the lower abdominal wall, which would make the hernia difficult and painful to repair later. This also reduces the risk of requiring emergency surgery.

The children recruited in this study were all less than six months old at the time of surgery.

Another major force of the study lies in the duration of monitoring of children. Those who underwent surgery remained under evaluation until they were five years old. At this age, children received standard tests of brain function that are known to predict future development. Normal tests at this age would show with great confidence that there was no harm to general anesthesia. And that turned out to be the case.

Each of these attributes means that the results are likely to be reliable and can be generalized from one country to another.

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Some things to consider

The only real weakness of the study is that the population evaluated is mainly male (84% of participants), the groin herniation being much more common in baby boys. The authors recognize this and emphasize the need to include more girls in future studies.

It is also important to note that to allow for a clear and precise answer, this study focused on only one episode of general anesthesia. It was not designed to evaluate the risk of repeated or exceptionally prolonged exposure to general anesthesia. So, it provides a piece of the puzzle, but not the complete picture.

Overall, this study is rebaduring for parents of children undergoing elective surgery. On a practical level, this allows other factors, such as surgical risk or the impact of postponing or avoiding the operation, to take a more prominent place in the taking of decision.

Parents may be worried about the general anesthesia that is hurting their baby's brain at the moment, at least for single operations.