Related Experiment Video
Updated: Dec 22, 2025

Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards
Published on: September 3, 2020
Evaluation of Neurotoxicity of Multiple Anesthesia in Children Using Visual Evoked Potentials
Sibel Oba1, Canan Tülay Işıl1, Hacer Şebnem Türk1
1Department of Anestesiology and Reanimation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Insights
Repeated anesthesia in children significantly alters Visual Evoked Potential (VEP) parameters, suggesting VEP may reliably assess anesthesia neurotoxicity in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Anesthesiology
Background:
- Anesthetic exposure in pediatric patients raises concerns regarding potential neurodevelopmental impacts.
- Traditional cognitive assessments for neurological changes in children can be subjective.
- Visual Evoked Potential (VEP) offers an objective measure of brain function via electrical signals in response to visual stimuli.
Purpose of the Study:
- To objectively evaluate the impact of multiple anesthetic exposures on pediatric brain function.
- To compare VEP responses in children with extensive anesthesia history versus those with no prior exposure.
- To determine if VEP can serve as a reliable indicator of anesthesia-induced neurotoxicity in children.
Main Methods:
- A prospective, single-blinded, randomized controlled study involved two groups of 25 children each.
- Group-P: Children with corrosive esophagitis and over 15 general anesthesia exposures.
- Group-C: Children with no prior anesthesia exposure. VEP (flash and pattern) was measured at least three days post-anesthesia for Group-P.
Main Results:
- Statistically significant differences were observed in the latencies and amplitudes of N2 and P2 components for both flash and pattern VEP between the two groups (p=0.000).
- These findings indicate altered neurophysiological responses in children with repeated anesthetic exposure.
Conclusions:
- Repeated anesthetic applications in children lead to significant alterations in VEP parameters.
- VEP responses show potential as a reliable, objective criterion for assessing anesthesia neurotoxicity in pediatric populations.
Objectives:
Anesthetic applications may cause increased neuronal damage in infants and children. Commonly cognitive or learning disability tests were used to investigate the neurological progress in children. Visual Evoked Potential is a gross electrical signal generated by the occipital regions of the cerebral cortex in response to visual stimulation and an objective assessment of brain function. In this study, to acquire more objective results, Visual Evoked Potential responses of children who had multiple exposures to anesthesia during the treatment of corrosive esophagitis were compared to children who have never received anesthesia before.
Methods:
In this prospective, single-blinded, randomized, controlled study, 25 children, who were admitted to our pediatric surgery clinic because of corrosive esophagitis and who received general anesthesia more than 15 times composed Group-P; 25 children, who admitted to our well-child-clinic and who had never received anesthesia before consisted Group-C. The flash and pattern VEP responses of both groups were measured at the electrophysiology laboratory without any anesthetic drug application. The VEP responses of children in Group-P were recorded at least three days after the last exposure to anesthesia.
Results:
Latencies and amplitudes of the N2 and P2 components of the pattern and flash VEP responses were statistically significantly different between the two groups (p=0.000).
Conclusion:
This study shows that in children who had repeated anesthetic applications VEP parameters are significantly altered. We believe that VEP responses may be a reliable objective criterion for the evaluation of anesthesia neurotoxicity.
Related Concept Videos
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Parenteral Anesthetics: Overview
Local Anesthetics: Clinical Application as Epidural Anesthesia
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...

