Understand the possible side effects of general anesthesia with an infant

Serious reactions to modern anesthesia are rare, especially for healthy patients. One concerning recent development in anesthesiology research is related to the potential of risks to children from exposure to general anesthesia. There is data from studies in juvenile animals linking medications used in general anesthesia to a negative impact on the growing brain. In humans, this period of risk may extend to age 2, but seems to become an issue only with repeated exposures. So far, research into this topic has been scant, with studies showing conflicting results. More research is needed to fully understand the issue.

In one study, Murdoch Children’s Research Institute in Australia measured the effects of anesthesia on over 700 infants, tracking the children to age 5. The study compared brain development of those who had received general anesthesia for less than one hour with kids who were treated with a local anesthetic. No significant difference in brain function was found between the two groups.

The U.S. Food and Drug Administration (FDA) advises that general anesthesia for a single, brief period is unlikely to affect learning or behavior. Research indicates that single, brief uses have minimal or no impact on a child’s brain development.

The FDA advises parents to discuss the risks and benefits when a child’s treatment requires repeated use of general anesthesia or a single use lasting more than three hours on a child younger than 3 years old. More research is needed to understand fully how anesthesia affects children’s brain development, according to the FDA.

Parents should talk with their child’s health care providers about balancing the benefits, risks and appropriate timing of procedures or surgery requiring general anesthesia.

Using a trained and experienced pediatric anesthesiologist

The risk of complications in childhood procedures and surgery requiring anesthesia also can be reduced by working with a pediatric anesthesiologist.

Anesthesiology at Norton Children’s

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“Those who are dealing with these small children on a daily basis are much more attuned to the issue of brain development. We are also much more comfortable with alternative medications or techniques that may be benign or protective,” said Steven M. Auden, M.D., chief of anesthesiology at Norton Children’s Hospital and pediatric anesthesiologist with Pediatric Anesthesia Associates. “Such measures include use of regional blocks (numbing certain areas), more reliance on medications that are not implicated in impacting neurodevelopment, and incorporating into the anesthetic care a medication that may be protective.”

In addition to clinical expertise treating children, pediatric anesthesiologists are experienced in helping young patients to be as calm and comfortable as possible, reducing excessive stress during a medical procedure.

Paying more attention to indirect parts of the child’s care — pain management, noise, sleep disruption and separation from a parent — can help to reduce stress for infants and young children.

Parents should have a clear understanding of the risks and rewards of pediatric anesthesia for their child. Together, parents and skilled health care providers can lessen the risks of general anesthesia in infants and young children, so your child can get the care they need, without unneeded risk.

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