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The effect of general anesthesia and strabismus surgery on the intellectual abilities of children: a pilot study
Hee Kyung Yang1, Dong Sun Chungh, Jeong-Min Hwang
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
General anesthesia and strabismus surgery in children aged 5-10 generally do not impact overall intellectual abilities. However, hand-eye coordination may be temporarily affected by changes in vision after surgery.
Area of Science:
- Pediatric Anesthesiology
- Pediatric Ophthalmology
- Developmental Psychology
Background:
- Strabismus surgery is common in children.
- General anesthesia is required for the procedure.
- Potential neurodevelopmental effects of anesthesia and surgery are a concern.
Purpose of the Study:
- To assess the impact of general anesthesia and strabismus surgery on children's intellectual abilities.
- To evaluate complex cortical functions before and after surgery.
Main Methods:
- Prospective observational study involving 21 children aged 5-10 years.
- Intellectual abilities assessed using the Kaufman Assessment Battery for Children (KABC) pre- and post-surgery.
- Four KABC subtests measuring complex cortical functions were analyzed.
Main Results:
- No significant overall change in intellectual ability scores was observed 4 weeks after surgery (P=.108).
- A significant decrease in the triangle test score (hand-eye coordination) was noted postoperatively (P=.019).
- This decrease was more pronounced in children with reduced postoperative stereoacuity.
Conclusions:
- General anesthesia with sevoflurane and strabismus surgery do not typically impair complex cortical functions in children aged 5-10 at 4 weeks post-op.
- Transient effects on hand-eye coordination may occur, potentially linked to changes in stereoacuity.
Purpose:
To determine the influence of general anesthesia and strabismus surgery on children's intellectual abilities.
Design:
Prospective, observational study.
Settings:
Institutional.
Patients:
Children 5 to 10 years of age receiving general anesthesia with sevoflurane and undergoing strabismus surgery were included. Intellectual abilities were examined before and 4 weeks after surgery using the Kaufman Assessment Battery for Children. Four subtests representing intellectual abilities related to complex cortical function were examined: identification of objects in a partially completed picture, reproduction of a presented design by using rubber triangles, selecting a picture that completes or is similar to another picture, and memory for location of pictures presented on a page.
Main Outcome Measures:
Preoperative and postoperative age-adjusted scores of the 4 subtests of the Kaufman Assessment Battery for Children.
Results:
The study group consisted of 21 children who underwent strabismus surgery under general anesthesia (mean duration, 51.3 minutes). The mean preoperative total score of the 4 subtests was 49.4±6.2. The mean postoperative total score adjusted for potential learning effects and test-retest reliability was 48.1±7.7. There was no significant postoperative change in the total score (P=.108). However, the triangle test score decreased significantly after operation (P=.019), particularly in patients with decreased stereoacuity after surgery.
Conclusions:
General anesthesia with sevoflurane and strabismus surgery generally do not affect the intellectual abilities of complex cortical function in children 5 to 10 years of age at 4 weeks after surgery. Cortical functions related to hand-eye coordination may be affected by transient changes in postoperative stereoacuity.
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