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Anesthesia Before Age 2 Linked to Learning Problems

Study Suggests Potential Risks of Anesthesia for Very Young Children

Anesthesia and the Developing Brain continued...

The study included 1,050 children born between 1976 and 1982 in a single school district in Rochester, Minn., enrolled in a larger health study.

A total of 350 children who had one or more surgeries requiring general anesthesia before age 2 were compared to 700 children with no such history.

Among the major findings:

  • About 37% of children who had had multiple surgeries requiring general anesthesia before age 2 had learning disabilities, compared to 24% of children who had just one surgery and 21% of children who had no surgeries.
  • After factoring in the impact of health status, having two or more surgeries requiring general anesthesia was associated with a twofold increase in learning disabilities.
  • Children who had two or more surgeries prior to age 2 were three to four times as likely to have been identified by their schools as needing special help for language and speech difficulties through an individualized education program (IEP) mandate.

Should Elective Surgery Be Delayed?

Although he calls the animal data compelling, University of Vermont associate professor of pediatrics and anesthesia Robert K. Williams, MD, says the impact of early exposure to general anesthesia on brain development probably will not be fully understood for years to come.

"It is very likely that we will be living with quite a bit of uncertainty about this for some time to come," he tells WebMD. "Trying to sort this out in humans is really hard because we are talking about subtle effects that may not show up until a child is well into school age."

Williams says the new research should alert pediatricians and parents to the issue.

"Whenever surgery is proposed on a small child -- or for that matter sedation for other reasons, including MRI scanning -- we need to make sure the procedure is truly indicated," he says. "If the answer is 'yes,' the question becomes, 'Can surgery be delayed until a later age without causing harm?"

In an editorial published with the study, Williams also recommended the use of local anesthesia when appropriate, noting that a local spinal anesthetic can be safely used for procedures such as circumcision and hernia repair.

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