Anesthesia poses no cognitive risk to healthy children under 3: study

A single exposure to general anesthesia poses no cognitive risk to healthy children under age three, a critical time in brain development, a U.S. study said Tuesday.

"A number of animal studies have suggested that exposure to commonly used anesthetic agents in early development could lead to deficits in learning, memory, attention, and other cognitive functions," said lead author Lena Sun, professor of pediatrics at the Columbia University in a statement.

"However, few clinical studies have adequately addressed whether this is also true in humans. Based on our findings, we can reassure parents that one exposure to anesthesia is safe for healthy young children," said Sun, also chief of pediatric anesthesiology at NewYork-Presbyterian/Morgan Stanley Children's Hospital.

The new study, called Pediatric Anesthesia Neurodevelopment Assessment (PANDA), examined whether exposure to a single anesthetic of short duration, which lasted for a median of 80 minutes, in children under age three had an effect on global cognitive function (IQ) later in life.

The study, published in the Journal of the American Medical Association, included 105 healthy children who underwent surgical repair of inguinal hernia -- one of the most common operations of early childhood.

IQ scores and secondary neurodevelopmental outcomes, including memory, learning, processing speed, visuospatial function, attention, executive function, language, and behavior, were assessed when the children were between the ages of eight and 15, allowing enough time after exposure to anesthesia for any impairments to emerge.

Outcomes for each child were compared to those of a healthy, biologically related sibling of a similar age who was not exposed to anesthesia.

"There was no significant difference in IQ scores between the children who were exposed to anesthesia and siblings who were not," said Sun.

"We also saw no difference in most of the secondary outcomes, although more children in the group exposed to anesthesia exhibited internalizing behavior that required further clinical evaluation. That's an area that needs to be further explored."

Internalizing behaviors are behaviors that are directed inward. Examples of negative or problematic internalizing behaviors include anxiety, social withdrawal, and feelings of loneliness and guilt.

"Overall, this is good news for parents whose children need anesthesia for elective surgery or a diagnostic procedure," said Sun.

An estimated 2 million children in the U.S. undergo anesthesia each year, roughly two-thirds for surgical procedures such as hernia repair, circumcision, and tonsillectomy. Anesthesia is also often used in diagnostic procedures, including imaging studies and endoscopies.

Previous scientific studies in young animals have shown that commonly used anesthetics can be harmful to the developing brain. However, results have been mixed in children. Some studies of infants and young children undergoing anesthesia have reported long-term deficits in learning and behavior, other studies have not. Endit