Anesthesia and children's developing brains

On Dec. 14, 2016 the U.S. Food and Drug Administration (FDA) issued a safety announcement regarding the potential effect of anesthetics on children younger than 3 years of age. The FDA announcement specific points to multiple repeated anesthetics and/or prolonged anesthesia over 3 hours. 

Some recent studies suggest that a single, short exposure to general anesthetic and sedation drugs in infants or toddlers is unlikely to have negative effects on behavior or learning. However, much more research is needed to fully understand how early life anesthetic exposure affects children’s brain development.

Surgery is scary enough: how should moms and dads evaluate the risk of anesthesia drugs and the possible effects on their baby? Studies are currently ongoing, aiming at characterizing how exposure to anesthesia drugs at a young age may affect children in the long run. The medical and scientific community does not have enough information to be able to draw definitive conclusions at this point. 

Open, honest conversations are recommended. Families and children's doctors should discuss these issues in the context of each child's care. If a surgery or procedure requiring anesthesia is definitely needed for the health of the child, it should not be delayed. However, if a procedure does not need to be done at an early age, it makes sense to consider the timing. These conversations should be addressed on an individual basis, and families should engage with their physicians to make sure they understand and feel comfortable with choices for their children. Remember, there are no "silly" or "minor" questions with the doctor... it is important for parents to understand and to feel comfortable with choices they are making together with their children's physicians: the choice is for the child and for the family. 

Here are more resources about this issue: 

• Anesthesia and Brain Development in Your Child (en Español) from the Texas Children's Hospital Department of Anesthesiology
• U.S. FDA Safety Announcement
• SmartTots (Strategies for Mitigating Anesthesia-Related neuroToxicity in Tots) 
• Texas Children's Hospital's Chief Anesthesiologist Dr. Dean Andropolous comments to the FDA, Science Board Meeting 2014 
• Download Anesthesia and Developing Brains - Implications of the FDA Warning, an informative perspective piece published in the New England Journal of Medicine