Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood

神经认知 医学 儿科 兄弟姐妹 麻醉 队列 神经心理学 麻醉剂 认知 队列研究 精神科 内科学 心理学 发展心理学
作者
Lena S. Sun,Guohua Li,Tonya Miller,Cynthia F. Salorio,Mary Byrne,David C. Bellinger,Caleb Ing,Raymond Park,Jerilynn Radcliffe,Stephen R. Hays,Charles DiMaggio,Timothy Cooper,Virginia Rauh,Lynne G. Maxwell,Ahrim Youn,Francis X. McGowan
出处
期刊:JAMA [American Medical Association]
卷期号:315 (21): 2312-2312 被引量:834
标识
DOI:10.1001/jama.2016.6967
摘要

Importance

Exposure of young animals to commonly used anesthetics causes neurotoxicity including impaired neurocognitive function and abnormal behavior. The potential neurocognitive and behavioral effects of anesthesia exposure in young children are thus important to understand.

Objective

To examine if a single anesthesia exposure in otherwise healthy young children was associated with impaired neurocognitive development and abnormal behavior in later childhood.

Design, Setting, and Participants

Sibling-matched cohort study conducted between May 2009 and April 2015 at 4 university-based US pediatric tertiary care hospitals. The study cohort included sibling pairs within 36 months in age and currently 8 to 15 years old. The exposed siblings were healthy at surgery/anesthesia. Neurocognitive and behavior outcomes were prospectively assessed with retrospectively documented anesthesia exposure data.

Exposures

A single exposure to general anesthesia during inguinal hernia surgery in the exposed sibling and no anesthesia exposure in the unexposed sibling, before age 36 months.

Main Outcomes and Measures

The primary outcome was global cognitive function (IQ). Secondary outcomes included domain-specific neurocognitive functions and behavior. A detailed neuropsychological battery assessed IQ and domain-specific neurocognitive functions. Parents completed validated, standardized reports of behavior.

Results

Among the 105 sibling pairs, the exposed siblings (mean age, 17.3 months at surgery/anesthesia; 9.5% female) and the unexposed siblings (44% female) had IQ testing at mean ages of 10.6 and 10.9 years, respectively. All exposed children received inhaled anesthetic agents, and anesthesia duration ranged from 20 to 240 minutes, with a median duration of 80 minutes. Mean IQ scores between exposed siblings (scores: full scale = 111; performance = 108; verbal = 111) and unexposed siblings (scores: full scale = 111; performance = 107; verbal = 111) were not statistically significantly different. Differences in mean IQ scores between sibling pairs were: full scale = −0.2 (95% CI, −2.6 to 2.9); performance = 0.5 (95% CI, −2.7 to 3.7); and verbal = −0.5 (95% CI, −3.2 to 2.2). No statistically significant differences in mean scores were found between sibling pairs in memory/learning, motor/processing speed, visuospatial function, attention, executive function, language, or behavior.

Conclusions and Relevance

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. Further study of repeated exposure, prolonged exposure, and vulnerable subgroups is needed.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
呆萌的雁荷完成签到,获得积分10
1秒前
小熊发布了新的文献求助10
2秒前
Dusk大寺柯完成签到 ,获得积分10
3秒前
万能图书馆应助念安采纳,获得10
4秒前
奶糖喵完成签到 ,获得积分10
4秒前
KY完成签到,获得积分10
5秒前
小康学弟完成签到 ,获得积分10
5秒前
liangmh发布了新的文献求助10
6秒前
hbu123完成签到,获得积分10
6秒前
李健应助夏你一跳采纳,获得10
7秒前
郑玉成完成签到,获得积分10
9秒前
cll完成签到,获得积分10
10秒前
sodarday完成签到,获得积分10
11秒前
11完成签到 ,获得积分10
11秒前
FashionBoy应助陈陈陈采纳,获得10
11秒前
z_zq完成签到,获得积分10
11秒前
听星伴月完成签到,获得积分10
11秒前
xhh完成签到 ,获得积分10
12秒前
正在完成签到,获得积分10
12秒前
CHENXIN532完成签到,获得积分10
12秒前
nater2ver完成签到,获得积分10
13秒前
lee完成签到,获得积分10
13秒前
研友_Raven完成签到,获得积分10
13秒前
现实的曼安完成签到 ,获得积分10
14秒前
Slemon完成签到,获得积分10
14秒前
Smoiy完成签到 ,获得积分10
14秒前
丰知然举报李金玉求助涉嫌违规
15秒前
19秒前
念惜完成签到 ,获得积分10
19秒前
领导范儿应助Meng采纳,获得10
19秒前
20秒前
20秒前
派总完成签到,获得积分10
22秒前
FOODHUA完成签到,获得积分10
22秒前
23秒前
wzjs完成签到 ,获得积分10
23秒前
hope完成签到,获得积分10
23秒前
桔梗完成签到,获得积分10
23秒前
24秒前
liujunhong完成签到,获得积分10
24秒前
高分求助中
Effect of reactor temperature on FCC yield 2000
Production Logging: Theoretical and Interpretive Elements 1500
Very-high-order BVD Schemes Using β-variable THINC Method 1000
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
Uncertainty Quantification: Theory, Implementation, and Applications, Second Edition 800
錢鍾書楊絳親友書札 600
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3288560
求助须知:如何正确求助?哪些是违规求助? 2925931
关于积分的说明 8424034
捐赠科研通 2596984
什么是DOI,文献DOI怎么找? 1416827
科研通“疑难数据库(出版商)”最低求助积分说明 659534
邀请新用户注册赠送积分活动 641903