Infant Anesthesia During Surgery May Affect White Matter In The Brain: Study

New research suggests that children who undergo surgery with general anesthesia while they are still an infant, under the age of one, may face increased risk of having decreased brain white matter later in life, raising concerns about child development. 

According to findings of a new small scale study published online by the medical journal Anesthesiology, children under one year of age who underwent general anesthesia have decreased white matter in their brains, compared to children who did not have surgery or general anesthesia.

Researchers from the University of Iowa Health Care examined data from the SmartTots study, a multi-year collaboration between the FDA and International Anesthesia Research Society. The study focuses on the safety of anesthesia and sedative drugs administered to young children.

A total of 33 children between the ages of 12 and 15 were included in the study, who underwent structural magnetic resonance imaging (MRI).

Of the 33, there were 17 children who were healthy, but had general anesthesia during surgery in the first year of their lives. The other 17 were control subjects who did not undergo surgery or general anesthesia.

The study findings indicated the volume and integrity of white matter in the brain was 1.5% lower in patients who had undergone surgery. No changes were seen to the gray matter in the brain.

White matter is the tissue in the brain that connects different parts of the brain and spinal cord to one another. It also allows the nerves to signal each other. Reductions in white matter may eventually lead to white matter disease, which is a disease that typically affects older people and results from aging. It can affect walking, balance, mood, impair learning, or affect the memory.

Last year, the FDA issued a warning against lengthy anesthesia or multiple rounds of general anesthesia and sedation in children under the age of three or pregnant women. The warning indicated anesthesia could damage a child’s brain development. The agency also said short rounds of anesthesia in infants and toddlers should be tolerated, however they added warning labels to anesthesia and sedation drugs.

Another study published in 2015 indicated young children face an increased risk of suffering impaired brain development after undergoing general anesthesia. Children who had undergone anesthesia early had lower scores on listening comprehension and IQ tests later in life.

Study authors aren’t clear on what the exact significance of a 1.5% decrease in white matter volume would mean for child development, and emphasize more research is needed.

Other studies have also focused on health effects of general anesthesia and surgery in infants under one and its effects on cognitive function. However, those studies have mainly used baby animals to form their conclusions, which is why researchers are calling for more studies involving humans.