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Anesthesia Exposure in the Young Child and Long-term Cognition: An Integrated Review

Audrey Rosenblatt1, Michael Kremer2, Barbara Swanson2

  • 1Rush University College of Nursing in Chicago, Illinois, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

AANA Journal
|October 5, 2019
PubMed

Insights

General anesthetics may impact children's brain development, with some studies showing no cognitive effects but others revealing negative outcomes like reduced gray matter density and increased learning disability risk.

Area of Science:

  • Neuroscience
  • Pediatric Anesthesiology
  • Developmental Psychology

Background:

  • General anesthetics are widely used in pediatric procedures.
  • Animal studies suggest potential neurotoxic effects of anesthetics on brain development.
  • The safety of anesthesia in young children remains a critical research area.

Purpose of the Study:

  • To review and evaluate existing human research on anesthesia-induced neurotoxicity in young children.
  • To synthesize findings on the cognitive and physical effects of anesthesia exposure in pediatric populations.

Main Methods:

  • A systematic literature search was conducted across three major databases.
  • Studies focusing on anesthesia exposure in infants and children were included.
  • The review analyzed reported clinical outcomes, including cognitive assessments and neuroimaging findings.

Main Results:

  • Some studies reported no significant differences in cognitive function between exposed and unexposed children.
  • Other research indicated negative outcomes, such as decreased gray matter density (occipital cortex, cerebellum) on MRI.
  • Negative outcomes also included lower performance IQ, impaired language skills, poorer academic achievement, and higher risk of learning disabilities.

Conclusions:

  • Human research presents mixed findings on the neurotoxicity of general anesthetics in children.
  • Evidence suggests potential risks including structural brain changes and adverse cognitive and academic consequences.
  • Further research is required to correlate cognitive function, physical brain changes, and disability risk in pediatric anesthesia exposure.

Keywords:
General anesthesianeurotoxicitypediatrics

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