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Long-term cognitive and behavioral outcomes following early exposure to general anesthetics

Caleb Ing1, David C Bellinger2,3,4

  • 1Departments of Anesthesiology and Epidemiology, Columbia University Vagelos College of Physicians and Surgeons and Mailman School of Public Health, New York, New York.

Current Opinion in Anaesthesiology
|July 5, 2022
PubMed

Insights

Children exposed to surgery and anesthesia showed no significant differences in intelligence. However, some studies indicate increased behavioral problems and attention-deficit hyperactivity disorder after general anesthesia exposure, especially with multiple exposures.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Outcomes
  • Behavioral Science

Background:

  • Numerous clinical studies have investigated neurodevelopmental outcomes in children after surgery and anesthesia.
  • Published results are mixed due to variations in study design, exposure types, patient populations, and outcome measures.

Purpose of the Study:

  • To review and synthesize findings from clinical studies on behavioral outcomes in children exposed to surgery and anesthesia.
  • To address the heterogeneity in existing research and provide a clearer understanding of potential neurodevelopmental effects.

Main Methods:

  • Systematic review of nearly 100 clinical studies.
  • Analysis of observational data on children's neurodevelopmental and behavioral outcomes following anesthetic exposure.

Main Results:

  • Children exposed to early surgery and anesthesia demonstrated limited to no differences in intelligence compared to unexposed peers.
  • Several studies reported increased behavioral problems in children exposed to general anesthesia.
  • An increased incidence of attention-deficit hyperactivity disorder was noted in anesthetic-exposed children, particularly after multiple exposures.

Conclusions:

  • Current evidence is primarily from observational studies, preventing direct attribution of behavioral deficits to anesthetic agents.
  • Observed deficits in specific neurodevelopmental domains can guide future research on anesthetic neurotoxicity.
  • Further studies are needed to definitively evaluate the impact of anesthetic medications on children's neurodevelopment.
Abstract

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