MedicalResearch.com Interview with:
James D. O’Leary, MD
Department of Anesthesia and Pain Medicine,
Child Health Evaluative Sciences
The Hospital for Sick Children
Department of Anesthesia, University of Toronto
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is substantial evidence from laboratory studies that the developing brain is susceptible to injury from general anesthetic drugs, which culminated in the US Food Drug Administration issuing a safety communication in 2017 stating that the use of general anaesthetic drugs “for lengthy periods of time or over multiple surgeries or procedures may negatively affect brain development in children younger than 3 years”. Considering the substantial number of children who require general anesthesia every year (almost 3 million in the US annually) even small differences in child development outcomes after surgical procedures that require general anesthesia may have significant public health implications.
Undertaking studies of anesthesia-related neurotoxicity in humans is difficult as adverse child development is a function of the complex interaction between many risk and protective factors. By examining differences between biological siblings in Ontario, Canada, this study seeks to mitigate differences in risk from biological vulnerability and environmental factors, to provide a more accurate estimate of the adverse effects of anesthesia and surgery on child development.
In the current study, young children who had surgical procedures that require general anesthesia were not found to be at increased risk of adverse child development outcomes compared to their biological siblings who did not have surgery. These findings further support that exposure to anesthesia and surgery in early childhood is not associated with detectable adverse child development outcomes.
MedicalResearch.com: What should readers take away from your report?
Response: The findings of the current study should reassure parents of young children who require anesthesia for surgical procedures.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: While the findings are generalizable to the majority of young children who have a single surgical procedure performed, it is still not known whether children with repeated or lengthy exposures to surgery and anesthesia are at increased risk of altered neurodevelopment. Interpreting the clinical implications of anaesthesia-related neurotoxicity is challenging and more definitive clinical studies providing high-quality evidence of a relationship between exposure to anaesthesia and neurological injury are still required to guide treatment decisions for children who are scheduled to undergo general anaesthesia
Disclosures: Dr. O’Leary is supported by a Young Investigator Award from the Society of Pediatric Anesthesia; no other competing interests.
O’Leary JD, Janus M, Duku E, et al. Influence of Surgical Procedures and General Anesthesia on Child Development Before Primary School Entry Among Matched Sibling Pairs. JAMA Pediatr. Published online November 05, 2018. doi:10.1001/jamapediatrics.2018.3662
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