Related Experiment Video

Updated: Apr 12, 2026

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain
08:23

Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Published on: May 12, 2018

10.0K

Association between childhood exposure to single general anesthesia and neurodevelopment: a systematic review and

Haifeng Zhang1, Lili Du2, Zijing Du1

  • 1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, China.

Journal of Anesthesia
|May 24, 2015
PubMed

Insights

Single general anesthesia before age 4 is linked to increased neurodevelopmental risks in children. However, the risk appears relatively safe after 3 years of age, suggesting careful consideration for early exposure.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Pediatrics
  • Evidence Synthesis

Background:

  • The relationship between general anesthesia and pediatric neurodevelopment remains debated, particularly for single exposures before age 4.
  • Existing studies lack a unified conclusion on the specific risks associated with early-life anesthesia.

Purpose of the Study:

  • To conduct a meta-analysis synthesizing current evidence on the association between single general anesthesia exposure and neurodevelopmental outcomes in children.
  • To specifically investigate the impact of anesthesia before ages 3 and 4 on learning disabilities, behavioral disorders, and cognitive problems.

Main Methods:

  • A systematic literature search was performed across PubMed, EMBASE, and Cochrane Library for studies published in the last decade.
  • Neurodevelopmental outcomes were evaluated, and synthesized hazard ratios (HR) with 95% confidence intervals (CI) were calculated.
  • Meta-regression analysis was employed to explore factors influencing the observed association.

Main Results:

  • Thirteen studies were included, revealing an association between single general anesthesia before age 4 and neurodevelopmental damage (adjusted HR 1.28, 95% CI 1.10-1.45).
  • The pooled adjusted HR was 1.17 (95% CI 1.07-1.28) before age 4 and 1.18 (95% CI 1.07-1.30) before age 3.
  • No significant difference in risk was found between exposure at 3 versus 4 years (HR3/HR4 = 1.008, p = 0.9), indicating anesthesia may be relatively safe after 3 years.

Conclusions:

  • Current evidence suggests a modest increase in the risk of neurodevelopmental disorders for children exposed to single general anesthesia around age 3.
  • A single general anesthesia appears relatively safe for children after 3 years of age.
  • Further prospective studies are recommended to establish causality due to the limitations of retrospective data.
Abstract

Keywords:
Anesthesia, general anestheticsCohort studiesInfantNeurodevelopmentalNewbornPediatrics

More Related Videos

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity AIDN: A Translational Neuroscience Approach06:38

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity AIDN: A Translational Neuroscience Approach

Published on: June 11, 2017

11.8K
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

88.5K

Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.1K
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
1.0K
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
2.4K
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
955
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
1.6K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
996