Anesthesia Before Age 2 Linked to Learning Problems
Study Suggests Potential Risks of Anesthesia for Very Young Children
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.
Pediatric surgeon Kevin P. Lally, MD, agrees that much uncertainty remains. But he says parents should not lose sight of the fact that surgeries often save the lives of very sick babies.
Lally chairs the American Academy of Pediatrics section of surgery. He also chairs the department of pediatric surgery at the University of Texas Medical School, Houston.
"It might be appropriate to delay a truly elective surgery, but they represent only a small percentage of procedures in very young children," he says. "Most surgeries cannot be delayed."