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Anesthesia in young kids may carry developmental risks

Anesthesia in young kids may carry developmental risks

POSTED: Monday, August 20, 2012 - 12:15pm

UPDATED: Monday, August 20, 2012 - 12:19pm

While surgery carries risks for anyone, "going under" can have some particular risks for the very young.

A study coming out in the September issue of Pediatrics finds that children who have anesthesia before the age of 3, are at a higher risk for developmental delay issues later in life.

The study looked at more than 2,600 children in Australia who were tracked as part of the Raine Study. Authors found that by the age of 10, children who'd been exposed to anesthesia at a young age were more than twice as likely to have developmental issues with listening and speaking comprehension.

"We can't determine if the cause is due to anesthesia, surgical stimulus, or the medical condition. It could be another factor entirely. We just know there's a difference," says Dr. Christopher Ing, assistant professor of pediatric anesthesiology at Columbia University Medical Center and lead author of the study.

Dr. David Warner, professor of anesthesiology at Mayo Clinic, has also been studying the impact anesthesia has on development. While he was not part of this study, Warner agreed that surgery and anesthesia introduce a whole host of factors that may impact a child's developmental outcome.

"It may be the surgery; it could be the underlying illness," explained Warner.

Previous studies have linked anesthesia in young children to increased risks in learning disabilities and ADHD. However this is the first study that has used a battery of neuropsychological tests to determine developmental delay. Previous studies relied on test scores, physician's diagnoses and medical records.

The children in the study were given tests that assessed their listening, speaking, and abstract reasoning skills. Children who had had anesthesia were 1.87 times more likely to have listening comprehension issues, 1.72 times more likely to have problems with speaking and 1.69 times more likely to have abstract reasoning delays. The combined risk factor for both listening and speaking issues was 2.11.

The group was also tested for behavior and motor function, but the authors found no significant difference in these skills between children who'd had anesthesia and those who hadn't.

The authors also compared children who had anesthesia once, versus 52 children in the study group who had it multiple times.

"We did see a difference in children with single and multiple exposure, but we couldn't statistically prove a difference, because we need more patients that had multiple exposures than were available in this study," said Ing.

But while there are risks, Ing also warned that further study needs to be done. "We don't enough evidence to change our current practices," he explained.

"Anytime you decide to do a procedure, you need to understand what the real benefits are," Warner says. "Parents need to ask, 'Do we really need to do this? How is this going to benefit my child?' In the vast majority (of cases), in kids this age, the benefits are real. But the risk is potential and not definite."

He added, "It's been established as a risk factor, and needs to be part of the conversation as parents talk to their doctors." 

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