Related Experiment Video
Updated: Dec 9, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early Childhood General Anesthesia and Neurodevelopmental Outcomes in the Avon Longitudinal Study of Parents and
Insights
Early exposure to general anesthesia and surgery in children was not linked to widespread neurodegeneration. However, it was associated with lower scores in motor skills and social communication.
Area of Science:
- Pediatric Anesthesiology
- Neurodevelopmental Pediatrics
- Epidemiology
Background:
- Anesthetic agents raise concerns for neurotoxicity in developing brains, prompting warnings for pediatric use.
- This study investigated the association between early exposure to general anesthesia and surgery and later neurodevelopmental outcomes.
Purpose of the Study:
- To determine if general anesthesia and surgery before age 4 are associated with adverse neurodevelopmental outcomes at ages 7 to 16.
- To assess a wide range of neurodevelopmental outcomes including motor, cognitive, linguistic, educational, social, and behavioral domains.
Main Methods:
- A prospective, population-based cohort study of 13,433 children (Avon Longitudinal Study of Parents and Children).
- Children were categorized by exposure (none, single, multiple) to general anesthesia and surgery before age 4.
- Neurodevelopmental outcomes were assessed between ages 7 and 16 using school results, questionnaires, and clinical assessments.
Main Results:
- No significant association was found between early anesthesia/surgery exposure and impairments in general cognitive ability, attention, memory, academic performance, or behavior.
- Children with single or multiple exposures showed significantly lower scores in dynamic balance and manual dexterity.
- Multiply exposed children had significantly lower social communication scores compared to unexposed children.
Conclusions:
- Early childhood exposure to general anesthesia and surgery is not associated with global neurodegenerative effects, offering reassurance regarding anesthetic neurotoxicity.
- Specific deficits in motor function and social communication were observed in children exposed to anesthesia and surgery.
- While not globally neurotoxic, the findings highlight potential impacts on specific developmental areas, warranting further investigation.
Background:
Most common anesthetic agents have been implicated in causing neurodegeneration in the developing animal brain, leading to warnings regarding their use in children. The hypothesis of this study was that exposure to general anesthesia and surgery before 4 yr would associate with adverse neurodevelopmental outcomes at age 7 to 16 yr.
Methods:
This cohort study comprised 13,433 children enrolled in the Avon Longitudinal Study of Parents and Children, a prospective, population-based birth cohort born between 1991 and 1993 in southwest England. Children were grouped by none, single, or multiple exposures to general anesthesia and surgery by 4 yr. Motor, cognitive, linguistic, educational, social, and behavioral developmental outcomes were evaluated at 7 to 16 yr using school examination results, validated parent/teacher questionnaires, or clinic assessments. Continuous outcomes were z-scored. P-value thresholds were corrected using false discovery rate procedures.
Results:
This study compared 46 neurodevelopmental outcomes in 13,433 children: 8.3% (1,110) exposed singly and 1.6% (212) exposed multiply to general anesthesia and surgery. Of these, the following reached predefined levels of statistical significance (corrected P < 0.00652): dynamic balance scores were 0.3 SD (95% CI, 0.1, 0.5; P < 0.001) lower in multiply exposed children; manual dexterity performance was 0.1 SD (95% CI, 0.0, 0.2; P = 0.006) lower in singly and 0.3 SD (95% CI, 0.1, 0.4; P < 0.001) lower in multiply exposed children; and social communication scores were 0.1 SD (95% CI, 0.0, 0.2; P = 0.001) and 0.4 SD (95% CI, 0.3, 0.5; P < 0.001) lower in singly and multiply exposed children, respectively. General anesthesia and surgery were not associated with impairments in the remaining neurodevelopmental measures including: general cognitive ability; attention; working memory; reading, spelling, verbal comprehension and expression; behavioral difficulties; or national English, mathematics, and science assessments (all ≤0.1 SD; corrected P ≥ 0.00652).
Conclusions:
Early childhood general anesthesia and surgery were not associated with a global picture of clinically and statistically significant neurodegenerative effects, providing reassurance about the neurotoxic potential of general anesthesia. Exposure to anesthesia and surgery was associated with significantly lower motor and social linguistic performance.
More Related Videos
08:23Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain
Published on: May 12, 2018
06:38Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity AIDN: A Translational Neuroscience Approach
Published on: June 11, 2017
Related Concept Videos
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:24Parenteral Anesthetics: Overview
01:22Stages of General Anesthesia
01:29Local 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...
01:12Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
01:20Inhalational Anesthetics: Overview