scholarly journals Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study

2021 ◽  
Author(s):  
Stephen J. Gleich ◽  
Yu Shi ◽  
Randall Flick ◽  
Michael J. Zaccariello ◽  
Darrell R. Schroeder ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Neurodevelopmental Outcomes ◽  
Multiple Exposures ◽  
Anesthesia Safety

scholarly journals Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort

2017 ◽  
Vol 127 (2) ◽  
pp. 227-240 ◽  
Author(s):  
Danqing Hu ◽  
Randall P. Flick ◽  
Michael J. Zaccariello ◽  
Robert C. Colligan ◽  
Slavica K. Katusic ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Learning Disabilities ◽  
General Anesthesia ◽  
Cognitive Ability ◽  
Birth Cohort ◽  
Attention Deficit ◽  
Population Based ◽  
Neurodevelopmental Outcomes ◽  
Hyperactivity Disorder ◽  
Multiple Exposures

Abstract Background Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. Methods A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models. Results For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability. Conclusions These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.

General anesthesia safety in progressive leukodystrophies: A retrospective study of patients with Krabbe disease and metachromatic leukodystrophy

2019 ◽  
Vol 29 (10) ◽  
pp. 1053-1059 ◽  
Author(s):  
Nicholas A. Bascou ◽  
Maria C. Marcos ◽  
Maria L. Beltran Quintero ◽  
Mercedes C. Roosen‐Marcos ◽  
Franklyn P. Cladis ◽  
...  
Keyword(s):  
Retrospective Study ◽  
General Anesthesia ◽  
Metachromatic Leukodystrophy ◽  
Krabbe Disease ◽  
Anesthesia Safety

scholarly journals Early Childhood General Anesthesia and Neurodevelopmental Outcomes in the Avon Longitudinal Study of Parents and Children Birth Cohort

2020 ◽  
Vol 133 (5) ◽  
pp. 1007-1020
Author(s):  
Graham J. Walkden ◽  
Hannah Gill ◽  
Neil M. Davies ◽  
Alethea E. Peters ◽  
Ingram Wright ◽  
...  
Keyword(s):  
Early Childhood ◽  
Longitudinal Study ◽  
General Anesthesia ◽  
Birth Cohort ◽  
Dynamic Balance ◽  
Statistical Significance ◽  
P Value ◽  
Neurodevelopmental Outcomes ◽  
Parents And Children ◽  
Avon Longitudinal Study

Background Most common anesthetic agents have been implicated in causing neurodegeneration in the developing animal brain, leading to warnings regarding their use in children. The hypothesis of this study was that exposure to general anesthesia and surgery before 4 yr would associate with adverse neurodevelopmental outcomes at age 7 to 16 yr. Methods This cohort study comprised 13,433 children enrolled in the Avon Longitudinal Study of Parents and Children, a prospective, population-based birth cohort born between 1991 and 1993 in southwest England. Children were grouped by none, single, or multiple exposures to general anesthesia and surgery by 4 yr. Motor, cognitive, linguistic, educational, social, and behavioral developmental outcomes were evaluated at 7 to 16 yr using school examination results, validated parent/teacher questionnaires, or clinic assessments. Continuous outcomes were z-scored. P-value thresholds were corrected using false discovery rate procedures. Results This study compared 46 neurodevelopmental outcomes in 13,433 children: 8.3% (1,110) exposed singly and 1.6% (212) exposed multiply to general anesthesia and surgery. Of these, the following reached predefined levels of statistical significance (corrected P < 0.00652): dynamic balance scores were 0.3 SD (95% CI, 0.1, 0.5; P < 0.001) lower in multiply exposed children; manual dexterity performance was 0.1 SD (95% CI, 0.0, 0.2; P = 0.006) lower in singly and 0.3 SD (95% CI, 0.1, 0.4; P < 0.001) lower in multiply exposed children; and social communication scores were 0.1 SD (95% CI, 0.0, 0.2; P = 0.001) and 0.4 SD (95% CI, 0.3, 0.5; P < 0.001) lower in singly and multiply exposed children, respectively. General anesthesia and surgery were not associated with impairments in the remaining neurodevelopmental measures including: general cognitive ability; attention; working memory; reading, spelling, verbal comprehension and expression; behavioral difficulties; or national English, mathematics, and science assessments (all ≤0.1 SD; corrected P ≥ 0.00652). Conclusions Early childhood general anesthesia and surgery were not associated with a global picture of clinically and statistically significant neurodegenerative effects, providing reassurance about the neurotoxic potential of general anesthesia. Exposure to anesthesia and surgery was associated with significantly lower motor and social linguistic performance. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Neurodevelopmental outcomes in infants undergoing general anesthesia

2017 ◽  
Vol 52 (6) ◽  
pp. 895-900 ◽  
Author(s):  
Kelsey A. Nestor ◽  
Michelle Zeidan ◽  
Erin Boncore ◽  
Aaron Richardson ◽  
Gijo Alex ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Neurodevelopmental Outcomes

scholarly journals Anesthesia for Cesarean Delivery and Learning Disabilities in a Population-based Birth Cohort

2009 ◽  
Vol 111 (2) ◽  
pp. 302-310 ◽  
Author(s):  
Juraj Sprung ◽  
Randall P. Flick ◽  
Robert T. Wilder ◽  
Slavica K. Katusic ◽  
Tasha L. Pike ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
General Anesthesia ◽  
Cesarean Delivery ◽  
Birth Cohort ◽  
Regional Anesthesia ◽  
Population Based ◽  
Perinatal Exposure ◽  
Neurodevelopmental Outcomes ◽  
Anesthetic Drugs

Background Anesthetics administered to immature brains may cause histopathological changes and long-term behavioral abnormalities. The association between perinatal exposure to anesthetics during Cesarean delivery (CD) and development of learning disabilities (LD) was determined in a population-based birth cohort. Methods The educational and medical records of all children born to mothers residing in five townships of Olmsted County, Minnesota from 1976-1982 and remaining in the community at age 5 were reviewed to identify those with LDs. Cox proportional hazards regression was used to compare rates of LD between children delivered vaginally and via CD (with general or regional anesthesia). Results Of the 5,320 children in this cohort, 497 were delivered via CD (under general anesthesia n = 193, and regional anesthesia n = 304). The incidence of LD depended on mode of delivery (P = 0.050, adjusted for sex, birth weight, gestational age, exposure to anesthesia before age 4 yr, and maternal education). LD risk was similar in children delivered by vagina or CD with general anesthesia, but was reduced in children receiving CD with regional anesthesia (hazard ratio = 0.64, 95% confidence interval 0.44 to 0.92; P = 0.017 for comparison of CD under regional anesthesia compared to vaginal delivery). Conclusion Children exposed to general or regional anesthesia during CD are not more likely to develop LD compared to children delivered vaginally, suggesting that brief perinatal exposure to anesthetic drugs does not adversely affect long-term neurodevelopmental outcomes. The risk of LD may be lower in children delivered by CD whose mothers received regional anesthesia.

Risk of ADHD After Multiple Exposures to General Anesthesia: A Nationwide Retrospective Cohort Study

2015 ◽  
Vol 22 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Chia-Jui Tsai ◽  
Charles Tzu-Chi Lee ◽  
Sophie Hsin-Yi Liang ◽  
Pei-Jung Tsai ◽  
Vincent Chin-Hung Chen ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Retrospective Cohort ◽  
Comorbid Conditions ◽  
Population Database ◽  
Age And Gender ◽  
Adhd Diagnosis ◽  
Multiple Exposures ◽  
Comparison Groups ◽  
Diagnosis Method ◽  
And Gender

Objective: To study the association between general anesthesia exposure before age 3 years and having a later ADHD diagnosis. Method: In a birth cohort, data were collected from a nationwide population database for children born between 1997 and 1999 who were exposed to general anesthesia before their third birthday. Age- and gender-matched enrollees without general anesthesia exposure were taken as the comparison. Groups were compared to identify the incidence of ADHD after age 4 and anesthesia-related predictive factors. Results: Among the 1,146 exposed children, 74 ADHD cases were identified, and 158 ADHD cases were identified in 3,438 matched controls. After adjusting for comorbid conditions and possible confounding factors, if exposure on more than one occasion or ≥3 hr, an increased likelihood of having a later ADHD diagnosis was found (HR, 1.71 and 2.43, respectively). Conclusion: Children with multiple or ≥3 hr general anesthesia exposures before age 3 years have an increased likelihood of a later ADHD diagnosis.

scholarly journals Does Exposure to General Anesthesia Increase Risk of ADHD for Children Before Age of Three?

2021 ◽  
Vol 12 ◽  
Author(s):  
Junjie Song ◽  
Huifang Li ◽  
Ying Wang ◽  
Chenguang Niu
Keyword(s):  
General Anesthesia ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Single Exposure ◽  
Hyperactivity Disorder ◽  
Multiple Exposures ◽  
Increase Risk ◽  
The Relationship ◽  
Subsequent Risk

Objective: The objective of the study was to evaluate the relationship between frequency of exposure to general anesthesia before the age of 3 and subsequent risk of diagnosis for attention-deficit hyperactivity disorder (ADHD).Method: We searched PubMed, Embase, Web of Science, and Cochrane Library database for eligible inclusion in the meta-analysis. The indicated outcomes were extracted from the included studies, and the combined effects were calculated using the RevMan software 5.3.Results: Compared with no exposure to general anesthesia, single exposure to general anesthesia did not increase the risk of ADHD for children before the age of 3 [hazard ratio (HR): 1.14, 95%; confidence intervals (CI): 0.97–1.35; p = 0.11; I2 = 0%], while multiple exposures to general anesthesia did increase the risk of ADHD (HR: 1.83; 95% CIs: 1.00–3.32; p = 0.05; I2 = 81%).Conclusion: Multiple, but not single, exposures to general anesthesia in children before age of 3 increased the risk of ADHD.

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