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Early Neurodevelopmental Outcomes Following Exposure to General Anesthesia in Infancy: EGAIN, a Prospective Cohort

Choon Looi Bong1, Duncun Ho2, John Carson Allen3

  • 1Department of Pediatric Anesthesia, KK Women's and Children's Hospital.

Journal of Neurosurgical Anesthesiology
|May 25, 2022
PubMed

Insights

A single exposure to general anesthesia (GA) in infancy did not impact cognitive, language, or motor skills at 24 months. However, GA-exposed children showed subtle behavioral differences and neurophysiological changes, suggesting a need for advanced assessments.

Area of Science:

  • Pediatric Neurodevelopment
  • Anesthesiology
  • Developmental Psychology

Background:

  • Early-life general anesthesia (GA) effects on neurodevelopment are debated in humans, despite animal studies indicating negative neural outcomes.
  • Previous human research on early GA exposure and neurodevelopment has yielded inconsistent findings.
  • This study investigates the impact of a single GA exposure for minor surgery on healthy children's neurodevelopment.

Purpose of the Study:

  • To assess the neurodevelopmental effects of a single general anesthesia exposure in healthy infants.
  • To utilize clinical, behavioral, and neurophysiological measures to evaluate outcomes at multiple time-points.
  • To compare neurodevelopmental trajectories between GA-exposed and non-exposed children.

Main Methods:

  • A prospective cohort of 250 healthy infants undergoing GA for minor surgery before 15 months was compared to a non-exposed cohort.
  • Clinical assessments included Bayley Scales of Infant and Toddler Development-III (BSID-III) and Child Behavior Checklist (CBCL1½-5) at 24 months.
  • Experimental tests for memory and attention, along with event-related potentials (neurophysiology), were conducted at 6 and 18 months.

Main Results:

  • No significant differences were observed in cognitive, language, or motor domains of the BSID-III at 24 months.
  • GA-exposed children exhibited poorer parent-reported scores for general adaptability (BSID-III) and higher internalizing behavior (CBCL1½-5).
  • Differences in 4 experimental tests related to memory and attention, and neurophysiological measures were detected at 6 and 18 months.

Conclusions:

  • Early single exposure to general anesthesia did not impair major neurodevelopmental outcomes by 24 months.
  • Subtle behavioral differences and altered neurophysiological responses were evident in infancy.
  • Neurophysiological assessments are valuable complements to clinical evaluations for understanding early GA exposure impacts.
Abstract

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