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Published on: October 16, 2013
Effect of one anesthetic exposure on long-term behavioral changes in children
Maen Chemaly1, Mariam A El-Rajab1, Fouad M Ziade2
1Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
Insights
Single anesthetic exposure in early childhood is linked to increased behavioral abnormalities by age 11. Factors like surgery type, anesthesia duration, and agent number significantly elevate this risk.
Area of Science:
- Pediatric Anesthesiology
- Developmental Psychology
- Neuroscience
Background:
- Anesthetic exposure in early childhood is a growing concern.
- Understanding long-term behavioral effects is crucial for patient safety.
Purpose of the Study:
- To investigate the association between a single anesthetic exposure before age 4 and behavioral outcomes at ages 10-12.
- To identify risk factors influencing behavioral abnormalities post-anesthesia.
Main Methods:
- Retrospective comparative study analyzing medical records.
- Included 292 children with one anesthetic exposure and 300 controls.
- Behavioral outcomes assessed using the Eyberg Child Behavior Inventory (ECBI).
Main Results:
- Children with one anesthetic exposure showed a significantly higher rate of behavioral abnormalities (28.4%) compared to controls (5.7%).
- Surgery exposure, longer anesthesia duration (>3 hrs), younger age at exposure (0-6 months), and multiple anesthetic agents increased abnormality risk.
- Specific risks noted: surgery (32.4%) vs. diagnostic procedures (4.8%), longer anesthesia (83.9%), younger age (48.8%).
Conclusions:
- A single anesthetic exposure before age 4 is associated with increased behavioral abnormalities by age 11.
- Younger age at exposure, longer duration, and use of multiple anesthetic agents are significant risk factors.
- Findings highlight the importance of minimizing early-life anesthetic exposure and considering procedural factors.
Study Objective:
To determine the association between one anesthetic exposure and behavioral outcome at age 10 to 12 years.
Design:
Retrospective comparative study.
Setting:
University-affiliated pediatrics department.
Measurements:
The medical records of children who underwent anesthesia between January 2004 and December 2005 at our institution were reviewed. The records of 292 children were included in the study group and 300 children in the control group. The study group involved children who had one anesthetic exposure before age of 4 years and the control group had children who were not exposed to anesthesia. The primary outcome was behavioral change as assessed by the Eyberg Child Behavior Inventory (ECBI) questionnaire.
Main Results:
The rate of behavioral abnormalities before the age of 11 years was 28.4% in the study group (P<0.001) and 5.7% in the control group. The risk of developing behavioral abnormalities was prominent in children being exposed to surgery versus those exposed during a diagnostic procedure (32.4% vs 4.8%; P<0.0001). Eighty-three point nine percent of the children who were exposed to longer duration anesthesia (more than 3 hrs) had behavioral abnormalities (P<0.0001), while 48.8% of children who received anesthesia at younger ages (0 - 6 mos) had behavioral abnormalities (P<0.0001). Exposure to multiple anesthetic agents versus one anesthetic agent was a significant risk factor for development of behavioral abnormalities (P<0.0001).
Conclusion:
The incidence of behavioral abnormalities increased when anesthesia and surgery were accompanied by younger age, longer duration of surgery, and use of multiple anesthetic agents.
