Well, the reports and concerns gained enough momentum last year where the Food and Drug Administration (FDA) recommended anesthesia use only when necessary to sedate children using the lowest possible doses. And while I found this recommendation interesting, and at its core, just good common sense, I now want to heighten the discussion around anesthesia use in young children following a new research article that will appear in next month’s journal of Pediatrics
So what researchers did was analyze a rather large birth cohort in Australia to look for a possible association between early anesthesia use and possible learning deficits later in childhood. Of the nearly 3,000 children in the cohort, researchers found 321 of them received anesthesia before age 3 for some sort of diagnostic or surgical procedure.
Interestingly enough, most of these procedures were considered minor, where ear tubes placement (for those children who a history of numerous ear infections) accounted for ¼ of the procedures. And when the children of this cohort turned 10 years of age, neurocognitive testing was performed to assess for things such as language development and abstract reasoning.
And as far as the key results from the analysis:
- For those children who were exposed to anesthesia before age 3, poorer scores were found to be statistically significant in the areas of receptive, expressive, and total language development.
- Again, in those children with early anesthesia use, deficits in abstract reasoning scores were also seen.
- In areas of behavior or motor function (i.e. running, throwing, etc.,) no statistically significant differences were found.
Now some research flaws certainly exist in this study and it is clear more and stronger research is needed before final conclusions should be made; but I am bringing this up to you because, bottom-line, it is impacting my thought process with the children I care for in my own practice. If an elective procedure/surgery can be delayed until a child is older, maybe it’s something worth considering. But, I also hesitate in calling procedures/surgeries such as the placement of ear tubes minor. Yes, in skilled surgical hands, no issues should arise but for the children who have a history of ongoing ear infections, the relief provided is major
- Dr. Jeremy
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