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Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

Giacomo Colletti1,2, Mattia Di Bartolomeo3, Sara Negrello4

  • 1Department of Medical and Surgical Sciences for Children & Adults, Cranio-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124 Modena, Italy.

Journal of Personalized Medicine
|May 27, 2023
PubMed

Insights

Multiple general anesthesia (mGA) in early childhood may increase the risk of neurodevelopmental delay. This systematic review highlights potential risks, emphasizing careful consideration of benefits versus risks for young patients undergoing mGA.

Area of Science:

  • Pediatric Anesthesiology
  • Developmental Neuroscience
  • Public Health

Background:

  • Multiple general anesthesia (mGA) in early life is a growing concern, prompting regulatory alerts.
  • Understanding the neurodevelopmental impact of mGA in children under four is critical.

Purpose of the Study:

  • To systematically review the literature on the neurodevelopmental effects of mGA in children under four years of age.
  • To synthesize evidence regarding potential risks associated with early-life exposure to mGA.

Main Methods:

  • A systematic literature search was conducted across Medline, Embase, and Web of Science databases up to March 31, 2021.
  • Included studies focused on pediatric patients under four years undergoing mGA, excluding case reports, animal studies, and expert opinions.
  • Ten studies, assessing over 275,000 children (11,027 exposed), were included in the final analysis.

Main Results:

  • The majority of included studies indicated a potential association between mGA before age four and neurodevelopmental delay.
  • Only one study found no statistically significant difference in neurodevelopmental outcomes between exposed and unexposed children.
  • A significant cohort size suggests a potential trend towards increased neurodevelopmental risks.

Conclusions:

  • Evidence from controlled studies suggests that children receiving mGA before the age of four may face a heightened risk of neurodevelopmental delay.
  • These findings underscore the importance of careful risk-benefit assessments for pediatric patients requiring multiple anesthetic exposures.
  • Further research may be warranted to fully elucidate the long-term neurodevelopmental consequences of early-life mGA.

Keywords:
early surgerymultiple general anesthesianeurocognitionneurodevelopment

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