Association between general anaesthesia exposure and neurodevelopment in children with congenital scoliosis at a Chinese tertiary hospital: study protocol for a prospective longitudinal observational cohort study

Ziyi Dai ¹, Yuelun Zhang ², Lulu Ma ³

⁰Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.

Bmj Open +

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December 3, 2025

View abstract on PubMed

Summary

This study investigates the impact of early general anesthesia on neurodevelopment in children with congenital scoliosis. Findings will inform parents and clinicians about potential anesthetic neurotoxicity risks.

Area Of Science

Pediatric Orthopedics
Neurodevelopmental Pediatrics
Anesthesiology

Background

General anesthesia may have neurotoxic effects, particularly with multiple or prolonged exposures.
Limited research exists on early anesthesia's impact on neurological development in children with congenital scoliosis.
Congenital scoliosis often necessitates multiple surgical interventions, increasing anesthesia exposure risk.

Purpose Of The Study

To assess the long-term effects of pre-school general anesthesia on neurocognitive function and behavior in children with congenital scoliosis.
To establish a baseline understanding of anesthetic neurotoxicity in this specific pediatric population.
To provide data for informed clinical decision-making regarding anesthesia in pediatric congenital scoliosis patients.

Main Methods

Prospective longitudinal observational cohort study of 150 children (aged 6-16) with congenital scoliosis.
Neurodevelopmental assessment using Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and Child Behaviour Checklist.
Analysis using linear mixed effects models to determine the impact of anesthesia exposure (none, single, multiple) before age 7.

Main Results

This section is not applicable as the study is prospective and results are not yet available.
The primary outcome is the full-scale intelligence quotient (IQ) estimated by WISC-IV.
Secondary outcomes include behavioral assessments and the impact of anesthesia exposure categories.

Conclusions

This study will provide crucial insights into the neurodevelopmental outcomes of children with congenital scoliosis undergoing early anesthesia.
Findings are expected to guide anesthetic practices and parental counseling for this vulnerable population.
Dissemination through publications and conferences will share knowledge on anesthetic neurotoxicity.

Keywords:

Anaesthesia in orthopaedics Cognition Paediatric anaesthesia Scoliosis