Long-term differences in language and cognitive function after childhood exposure to anesthesia.
Caleb Ing,Charles DiMaggio,Andrew J. O. Whitehouse,Mary Hegarty,Joanne E. Brady,Britta S. von Ungern-Sternberg,Britta S. von Ungern-Sternberg,Andrew Davidson,Alastair J. J. Wood,Guohua Li,Lena S. Sun +10 more
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TLDR
Children in this cohort exposed to anesthesia before age 3 had a higher relative risk of language and abstract reasoning deficits at age 10 than unexposed children, indicating that the association between anesthesia and neuropsychological outcome may be confined to specific domains.Abstract:
BACKGROUND: Over the past decade, the safety of anesthetic agents in children has been questioned after the discovery that immature animals exposed to anesthesia display apoptotic neurodegeneration and long-term cognitive deficiencies. We examined the association between exposure to anesthesia in children under age 3 and outcomes in language, cognitive function, motor skills, and behavior at age 10. METHODS: We performed an analysis of the Western Australian Pregnancy Cohort (Raine) Study, which includes 2868 children born from 1989 to 1992. Of 2608 children assessed, 321 were exposed to anesthesia before age 3, and 2287 were unexposed. RESULTS: On average, exposed children had lower scores than their unexposed peers in receptive and expressive language (Clinical Evaluation of Language Fundamentals: Receptive [CELF-R] and Expressive [CELF-E]) and cognition (Colored Progressive Matrices [CPM]). After adjustment for demographic characteristics, exposure to anesthesia was associated with increased risk of disability in language (CELF-R: adjusted risk ratio [aRR], 1.87; 95% confidence interval [CI], 1.20–2.93, CELF-E: aRR, 1.72; 95% CI, 1.12–2.64), and cognition (CPM: aRR, 1.69; 95% CI, 1.13–2.53). An increased aRR for disability in language and cognition persisted even with a single exposure to anesthesia (CELF-R aRR, 2.41; 95% CI, 1.40–4.17, and CPM aRR, 1.73; 95% CI, 1.04–2.88). CONCLUSIONS: Our results indicate that the association between anesthesia and neuropsychological outcome may be confined to specific domains. Children in our cohort exposed to anesthesia before age 3 had a higher relative risk of language and abstract reasoning deficits at age 10 than unexposed children.read more
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Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial
Andrew Davidson,Nicola Disma,Jurgen C. de Graaff,Davinia E. Withington,Liam Dorris,Graham Bell,Robyn Stargatt,Robyn Stargatt,David C. Bellinger,David C. Bellinger,Tibor Schuster,Sarah J Arnup,Pollyanna Hardy,Rodney W. Hunt,Rodney W. Hunt,Michael Takagi,Gaia Giribaldi,Penelope L Hartmann,Ida Salvo,Neil S. Morton,Britta S von Ungern Sternberg,Britta S von Ungern Sternberg,Bruno Guido Locatelli,Niall C. T. Wilton,Anne M. Lynn,Joss J. Thomas,David M. Polaner,Oliver Bagshaw,Peter Szmuk,Anthony Absalom,Geoff Frawley,Charles B. Berde,Gillian D Ormond,Jacki Marmor,Mary Ellen McCann +34 more
TL;DR: This trial found no evidence that just under an hour of sevoflurane anaesthesia in infancy increases the risk of adverse neurodevelopmental outcome at two years of age compared to RA.
Journal ArticleDOI
Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood
Lena S. Sun,Guohua Li,Tonya L. K. Miller,Cynthia F. Salorio,Mary W. Byrne,David C. Bellinger,Caleb Ing,Raymond Park,Jerilynn Radcliffe,Stephen R. Hays,Charles DiMaggio,Timothy J. Cooper,Virginia Rauh,Lynne G. Maxwell,Ahrim Youn,Francis X. McGowan +15 more
TL;DR: Among healthy children with a single anesthesia exposure before age 36 months, compared with healthy siblings with no anesthesia exposure, there were no statistically significant differences in IQ scores in later childhood.
Journal ArticleDOI
Neuropsychological and Behavioral Outcomes after Exposure of Young Children to Procedures Requiring General Anesthesia: The Mayo Anesthesia Safety in Kids (MASK) Study.
David O. Warner,Michael J. Zaccariello,Slavica K. Katusic,Darrell R. Schroeder,Andrew C. Hanson,Phillip J. Schulte,Shonie L. Buenvenida,Stephen J. Gleich,Robert T. Wilder,Juraj Sprung,Danqing Hu,Robert G. Voigt,Merle G. Paule,John J. Chelonis,Randall P. Flick +14 more
TL;DR: The hypothesis that exposure to multiple, but not single, procedures requiring anesthesia before age 3 yr is associated with adverse neurodevelopmental outcomes is suggested, and changes in specific neuropsychological domains that are associated with behavioral and learning difficulties are suggested.
Journal ArticleDOI
Propofol-induced apoptosis of neurones and oligodendrocytes in fetal and neonatal rhesus macaque brain
Catherine E. Creeley,Krikor Dikranian,Gregory A. Dissen,Lauren D. Martin,John W. Olney,Ansgar M. Brambrink,Ansgar M. Brambrink +6 more
TL;DR: Exposure of fetal or neonatal NHP brain to propofol caused a significant increase in apoptosis of neurones, and of OLs at a stage when OLs were just beginning to myelinate axons, which indicates OLs become vulnerable to the apoptogenic action of prop ofol when they are beginning to achieve myelination competence.
Journal ArticleDOI
Lasting impact of general anaesthesia on the brain: mechanisms and relevance.
Laszlo Vutskits,Zhongcong Xie +1 more
TL;DR: Available mechanistic data linking general-anaesthesia exposure to impaired cognitive performance in both young and mature nervous systems are reviewed, providing a critical appraisal of the translational value of animal models.
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Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial
Andrew Davidson,Nicola Disma,Jurgen C. de Graaff,Davinia E. Withington,Liam Dorris,Graham Bell,Robyn Stargatt,Robyn Stargatt,David C. Bellinger,David C. Bellinger,Tibor Schuster,Sarah J Arnup,Pollyanna Hardy,Rodney W. Hunt,Rodney W. Hunt,Michael Takagi,Gaia Giribaldi,Penelope L Hartmann,Ida Salvo,Neil S. Morton,Britta S von Ungern Sternberg,Britta S von Ungern Sternberg,Bruno Guido Locatelli,Niall C. T. Wilton,Anne M. Lynn,Joss J. Thomas,David M. Polaner,Oliver Bagshaw,Peter Szmuk,Anthony Absalom,Geoff Frawley,Charles B. Berde,Gillian D Ormond,Jacki Marmor,Mary Ellen McCann +34 more