The development of general anesthesia revolutionized the area of surgery; however, similar to most all medical procedures, risks are involved that vary by the patient’s health status as well as the length and complexity of the procedure. A new study has found that administering a general anesthetic to a young child may result in harm to cognition and brain structure. The findings were published in the journal Pediatrics by researchers at Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; and University of Cincinnati College of Medicine, Cincinnati, Ohio.
The study authors note that general anesthesia has been found to cause cell death, destruction of neurons (brain cells), and cognitive impairment in young animals. Thus, significant concern exists that it may have similar effects on young children. They explain that studies currently available in the medical literature have not fully address this concern. Therefore, they conducted a study to assess the impact of general anesthesia on children.
The investigators compared healthy children at age 5 to 18 years who had undergone surgery with anesthesia before four years of age (53 children) to children who had not undergone general anesthesia (53 children). The subjects were matched for age, gender, handedness (right or left handed), and socioeconomic status. The neurocognitive evaluation included the Oral and Written Language Scales and the Wechsler Intelligence Scales, as appropriate for age. Brain structural comparisons were conducted via the use of magnetic resonance imaging (MRI) scans.
The researchers found that. Regardless of anesthesia history, the average test scores were within population norms. However, compared to control subjects, previously exposed children scored significantly lower in listening comprehension and performance IQ. Anesthesia exposure did not lead to gross elimination of gray matter, which was reported in previous animal studies; however, decreased performance IQ and language comprehension were associated with lower gray matter density in the occipital cortex and cerebellum. The occipital cortex is the visual processing center of the brain. The cerebellum plays an important role in motor control and may also be involved in some cognitive functions such as attention and language, and in regulating fear and pleasure responses.
The authors concluded that their findings suggest that general anesthesia for a surgical procedure in early childhood may be associated with long-term reduction of language abilities and cognition, as well as decreased volume in some areas of the brain. They note that the cause for these changes is unclear at present, their findings underscore the need for further research into this process and the development of preventive strategies.
