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No Evidence of Long-Term Adverse Neurodevelopmental Outcomes in Young Children Exposed to General Anaesthesia

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Author: Erika Powers

DG News

Young children who are exposed to general anaesthesia do not appear to have long-term adverse neurodevelopmental outcomes, according to a study presented at Anesthesiology 2021, the Annual Meeting of the American Society of Anesthesiologists (ASA).

Yu Shi, MD, Mayo Clinic, Rochester, Minnesota, and colleagues assessed 33 girls and 28 boys aged 2.5 to 6 years who were scheduled to receive general anaesthesia for elective surgery at Mayo Clinic between September 2018 and September 2020. The researchers measured cognitive function preoperatively (visit 1), at 1 to 2 weeks postoperatively (visit 2), and then 3 months following surgery (visit 3).

Ear, nose, and throat procedures were the most common procedures performed (70%), and the median duration under anaesthesia was 75 minutes. Of the patients, 23 (38%) had undergone prior general anaesthesia.

“When comparisons were made between visits, most of the cognitive outcomes had stable scores,” said Dr. Shi.

At visit 2, there were improvements in mean picture memory scores (visit 1, 10.6; visit 2, 11.5; visit 3, 11.2; P = .016)), in mean cancellation scores (10.4, 11.8, and 11.6, respectively; P = .001), and processing speed composite scores (103, 110, and 107, respectively; P = .001).

Statistically significant improvement in Mullen fine motor score was noticed at visit 3 (44.1) compared to visit 1 (42.7; P = .022).

No significant changes in any other measures were found comparing visit 3 to visit 2.

“In young children who undergo general anesthesia for elective surgery, no measurable decline in cognition function in the domains of working memory, processing speed, and fine motor skills was found up to 3 months after the surgery,” said Dr. Shi.

The most commonly administered preoperative medication was midazolam (52%), and the most commonly administered intraoperative medications were fentanyl (85%), anaesthetic gas (97%), propofol (79%), and dexmedetomidine (34%). Of the patients, 51% had ASA 1 status, 41% ASA 2 status, and 8% ASA 3 status.

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