Surgical Anesthesia May Harm Young, Developing Brains: Study

Children who are administered general anesthesia during surgery may face an increased risk of suffering impaired brain development, according to the findings of new research. 

In a study published in the medical journal Pediatrics on June 8, researchers found children who received general anesthesia before the age of 4 had lower scores on listening comprehension and IQ tests when they were older, compared to children who never received general anesthesia.

Researchers looked at 50 children between the ages of 5 to 18 who were a part of a language development study and also underwent surgery with general anesthesia before the age of 4. They compared these children to 50 other children who were never exposed to general anesthesia. They were matched for age, gender, handedness and socioeconomic status.

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Children who were previously exposed to general anesthesia scored significantly lower on the two types of tests.

“General anesthesia for a surgical procedure in early childhood may be associated with long-term diminution of language abilities and cognition, as well as regional volumetric alterations in brain structure,” said study author Dr. Andreas Loepke, professor of clinical anesthesia and pediatrics at the University of Cincinnati College of Medicine.

Children underwent a neurocognitive assessment and brain structural comparisons were conducted using and MRI. Overall, average test scores were within population norms regardless of surgical history. Children who received general anesthesia had IQ scores that averaged 3 to 6 points lower than the children who didn’t have surgery.

Exposure to general anesthesia did not lead to gross elimination of gray matter in regions previously identified as vulnerable in animals. Decreased performance IQ and language comprehension are associated with lower gray matter density in the occipital cortex and cerebellum in the brain, the researchers said.

Researchers noted that prior studies on animals have shown that anesthesia induces widespread cell death, permanent neuronal deletion and neurocognitive impairment in immature animals. This is what spurred the study to focus on the effects of young children.

The results of the animal study spurred a child anesthesia group known as SmartTots to release a report calling for a large scale study of children and the effects of general anesthesia on development. The FDA report was released earlier this year and calls for more research, cautioning against using anesthesia on young children unless the procedure is absolutely necessary.

A link between anesthesia in children and language deficits were also found in two other studies published in 2011 and 2012.

“These concerns make it obvious that a lot more research is needed to better understand the effects of anesthetics on brain development,” said Loepke.

Other factors need to be considered as well. Researchers warn that surgery may have unknown effects like inflammation, pain or cause an underlying medical problem that needs to be treated.

The majority of the children in this study underwent surgery for ear, nose or throat conditions, especially hearing conditions. General surgery and urology were two of the other common surgery types.

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