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Anesthesia May Harm Children's Brains

Study: Anesthesia Before Age 3 Linked to Later Mental Problems

Unanswered Questions

The study leaves many important questions unanswered.

Because the researchers didn't have access to the children's medical records, they weren't able to tell which drugs were used or how long the procedures lasted.

And the most commonly used drug for anesthesia in children during the study years was halothane, a drug that's since been discontinued.

Newer drugs that have replaced it work in much the same way, so the study findings are probably still relevant, says Randall Flick, MD, a pediatric anesthesiologist at the Mayo Clinic in Rochester, Minn.

Even nitrous oxide, which is often used in dental procedures, is a concern, he says.

"Nitrous oxide has its own set of problems in addition to neurotoxicity. Most people in pediatric anesthesia are getting away from using nitrous oxide for any reason," though dentists, he says, haven't made the switch.

"I don't think at this point in time that one can say this is absolutely the anesthesia. It could be that anesthesia is a marker for this type of thing," Sun says.

Other experts who weren't involved in the study agree that it's too early to sound the alarm.

"The study is very well done and is an important study, but we have to be careful about over-interpreting," Flick says.

Flick chairs an FDA committee that's looking into the safety of sedating drugs in children.

After a meeting last April to review the evidence, "It was the consensus of the group that there should be no communication to the American public regarding this concern because the evidence wasn't sufficient to warrant that," Flick says.

The new study wouldn't change that stance, he says.

But Flick admits that it's getting tough to ignore the mounting evidence that's pointing to potential problems.

Research in animals shows that anesthetic drugs can speed up cell death and may keep developing brains from forging important connections between neurons.

Evidence in humans, however, is mixed and less direct.

Advice to Parents

Deciding whether a child should have surgery is always difficult. The risks from anesthesia are something to consider.

But what are the risks, exactly? Experts say that's a question that doesn't have a good answer.

"We don't know whether the problem is a real one, and if it's a real one, we don't know how to avoid it," says Michael Roizen, MD, an anesthesiologist who is chief wellness officer at the Cleveland Clinic, in Ohio.

Roizen also chairs the SmartTots campaign, which is a joint project of the FDA and the International Anesthesia Research Society. SmartTots is funding studies on the safety of anesthesia in kids.

Until more is known, Roizen says parents shouldn't panic.

"If the child needs surgery, there is no way of avoiding [anesthesia] right now," Roizen tells WebMD. "The goal is to have the shortest period of time of anesthesia as possible."

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