In infants, an hour of general anesthesia - long enough for most minor surgeries done in babies - doesn't increase the risk of impaired brain development compared to an hour of regional anesthesia, a study suggests. By age three, roughly one in 10 children in developed countries will have had general anesthesia at least once for things like repairing a hernia, placing ear tubes, removing tonsils or completing MRIs, researchers note in The Lancet.
Parents sometimes try to delay these interventions until children are older, out of concern that general anesthesia may impair brain development in kids. But research to date on this connection has yielded mixed results and relied primarily on animal studies. For the current analysis, researchers randomly assigned 722 infants in seven countries undergoing hernia repair surgery to receive either general anesthesia or a spinal block, a type of regional anesthesia. Kids who had general anesthesia were unconscious for an average of 54 minutes.
At age five, the kids had similar test scores from assessments of IQ, attention, memory, executive function and behavior, regardless of which anesthesia they had, the study found. "The trial finds the strongest evidence to date that an hour of anesthesia does not increase risk of later cognitive or most other neurodevelopmental problems," said senior study author Dr. Andrew Davidson of Royal Children's Hospital and the Murdoch Children's Research Institute in Melbourne, Australia.
"There are some aspects of neurodevelopment that manifest later in life and the trial does not address, these however the results at five years of age are very reassuring," Davidson said by email. "We cannot conclude that longer exposures are safe, however the majority of anesthetics in children are under an hour," Davidson said.
The results offer some of the strongest evidence to date that parents don't need to delay surgical procedures for infants and toddlers out of concern that general anesthesia might harm their developing brains, the researchers conclude.
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