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Cognitive and behavioral outcomes after early exposure to anesthesia and surgery

Randall P Flick1, Slavica K Katusic, Robert C Colligan

  • 1Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. flick.randall@mayo.edu

Pediatrics
|October 5, 2011
PubMed

Insights

Repeated exposure to anesthesia before age 2 increased the risk of learning disabilities in children. Multiple anesthetic exposures, not single ones, were linked to these developmental risks.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Pediatrics
  • Epidemiology

Background:

  • Millions of children undergo anesthesia annually, with animal studies indicating potential neurodegenerative effects.
  • Early-life anesthetic exposure is a growing concern for potential long-term neurodevelopmental impacts in children.

Purpose of the Study:

  • To investigate the association between early-life anesthesia exposure and later learning disabilities (LDs).
  • To examine the link between anesthesia exposure and individualized education programs for emotional/behavior disorders (IEP-EBD).
  • To assess the impact of anesthesia on cognitive and achievement test scores in children.

Main Methods:

  • A matched cohort study of 8548 children born between 1976-1982 in Rochester, Minnesota.
  • 350 children exposed to anesthesia before age 2 were matched with 700 unexposed controls.
  • Multivariable analysis adjusted for illness burden to evaluate outcomes like LDs, IEP-EBD receipt, and test scores.

Main Results:

  • Multiple exposures to anesthesia/surgery before age 2 significantly increased the risk of developing learning disabilities (HR: 2.12).
  • Similar patterns of decrements were observed in cognitive and achievement test scores.
  • Anesthesia exposure did not significantly affect the rate of children receiving an IEP-EBD.

Conclusions:

  • Repeated anesthesia and surgery before age 2 is an independent risk factor for later learning disabilities.
  • Early-life multiple anesthetic exposures may adversely affect human neurodevelopment with lasting consequences.
  • The study did not find a link between early anesthesia exposure and the need for emotion/behavior-related educational interventions.
Abstract

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