Journal article
The effects of early anesthesia on neurodevelopment: A systematic review
Journal of pediatric surgery, v 56(5), pp 851-861
01 May 2021
PMID: 33509654
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: There is growing concern regarding the impact of general anesthesia on neurodevelopment in children. Pre-clinical animal studies have linked anesthetic exposure to abnormal central nervous system development, but it is unclear whether these results translate into humans. The purpose of this systematic review from the American Pediatric Surgical Association (APSA) Outcomes and Evidence-Based Practice (OEBP) Committee was to review, summarize, and evaluate the evidence regarding the neurodevelopmental impact of general anesthesia on children and identify factors that may affect the risk of neurotoxicity.
Methods: Medline, Cochrane, Embase, Web of Science, and Scopus databases were queried for articles published up to and including December 2017 using the search terms "general anesthesia and neurodevelopment" as well as specific anesthetic agents. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to screen manuscripts for inclusion in the review. A consensus statement of recommendations in response to each study question was synthesized based upon the best available evidence.
Results: In total, 493 titles were initially identified, with 56 articles selected for full analysis and 44 included for review. Based on currently available developmental assessment tools, a single exposure to general anesthesia does not appear to have a significant effect on general neurodevelopment, although prolonged or multiple anesthetic exposures may have some adverse effects. Exposure to general anesthesia may affect different domains of development at different ages. Regional anesthetic techniques with the addition of dexmedetomidine and/or some intravenous agents may mitigate the risks of neurotoxicity. This approach may be performed safely in some patients and can be considered as an option in selected short procedures.
Conclusion: There is no conclusive evidence that a single short anesthetic in infancy has a detectable neurodevelopmental effect. Data do not support waiting until later in childhood to perform general anesthesia for single short procedures. With the complexities and nuances of different anesthetic methods, patients and procedures, the planning and execution of anesthesia for the pediatric patient is generally best accomplished by an anesthesiologist, ideally a pediatric anesthesiologist. Type of study: Systematic review of level 1 -4 studies. Level of evidence: Level 1 -4 (mainly level 3 -4) (c) 2021 Elsevier Inc. All rights reserved.
Metrics
Details
- Title
- The effects of early anesthesia on neurodevelopment: A systematic review
- Creators
- Julia Grabowski - Lurie Children's HospitalAdam Goldin - Seattle Children's HospitalL. Grier Arthur - St. Christopher's Hospital for ChildrenAlana L. Beres - University of California, DavisYigit S. Guner - Children's Hospital of Orange CountyYue-Yung Hu - Northwestern UniversityAkemi L. Kawaguchi - College Station Medical CenterLorraine I. Kelley-Quon - University of Southern CaliforniaJarod P. McAteer - AnchorageDoug Miniati - Kaiser Permanente Roseville Medical CenterElizabeth J. Renaud - Hasbro Children's HospitalRobert Ricca - Naval Medical Center PortsmouthMark B. Slidell - Comer Children's HospitalCaitlin A. Smith - Seattle Children's HospitalJuan E. Sola - University of MiamiStig Somme - College Station Medical CenterCynthia D. Downard - University of LouisvilleAnkush Gosain - University of Tennessee Health Science CenterPatricia Valusek - Children's MinnesotaShawn D. St Peter - Sisters of Mercy Health SystemNarasimhan 'Sim' Jagannathan - Lurie Children's HospitalRoshni Dasgupta - Cincinnati Children's Hospital Medical Center
- Publication Details
- Journal of pediatric surgery, v 56(5), pp 851-861
- Publisher
- Elsevier
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:000649635700006
- Scopus ID
- 2-s2.0-85099830610
- Other Identifier
- 991021969474604721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics
- Surgery