One Exposure to Anesthesia in Children Does Not Cause Learning Disabilities, New Research Shows

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“All the animal studies have been very consistent, very robust,” Dr. Sun said. The association observed in animal studies between the prolonged drug exposure and the effects made it imperative to find ways to look at children.

In 2017, after reviewing existing evidence, the Food and Drug Administration warned that long anesthetic exposures or multiple exposures might affect brain development in young children, so parents and pregnant women should discuss the potential risks with their doctors.

Some retrospective studies suggested associations between multiple surgeries with anesthesia and later learning disabilities. But children who required two or three major operations and developed learning disabilities later in life can’t be easily compared with children who had no operations without taking into account the medical problems that were the reason for the anesthesia exposures and all the other possible effects of those medical problems and their treatments.

Dr. Sun, one of the first people to sound the alarm about a possible long-term impact of general anesthesia, was the lead investigator on the Pediatric Anesthesia Neurodevelopment Assessment study, known as the Panda study (acronyms are very important in medical trials, maybe especially when children are involved). It used pairs of siblings to look at the association between a single exposure to general anesthesia before a child was 3, and later cognitive function. The results, published in 2016, showed that there was no statistically significant difference between the siblings who were exposed and those who were not, in I.Q. and other tests of neurocognitive function and behavior.

And now the new study, which represents a huge international collaborative effort, shows that single, relatively brief exposures to anesthesia did not lead to learning problems.

“They’re very important studies since most exposures are single brief exposures,” said Dr. Randall Flick, professor of anesthesiology and pediatrics at the Mayo Clinic Children’s Center. The average duration of anesthesia in children is about an hour.

The pattern that emerged from early studies, Dr. Flick said, is that “a single exposure prior to age 3 or 4 seemed to have no impact on the frequency of diagnosis of a specific learning disability in children, but once you had two or more anesthetic exposures you saw a near-doubling of the frequency.”



Source : Nytimes