Surgery for a child can be a difficult decision. One of the worries is the effect of anesthesia on a developing brain.
A new paper in the Journal of the American Medical Association Pediatrics shows no significant association between anesthesia and the mental development of a child.
Dr. Pia Glatz from the Section of Anesthesia and Intensive Care Medicine at the Karolinska Institute in Sweden and colleagues used data from a combined national Swedish registry to analyze academic grades at age 16 and IQ scores of 33,000 children who were exposed to a single surgery with anesthesia before the age of 4.
Researchers then compared these grades and IQ scores to 159,000 children who were not exposed to anesthesia.
The most common surgeries children underwent were hernia repair (30 percent), ear, nose, throat surgery (20 percent), abdominal surgery (13 percent), and orthopedic surgery (12 percent).
They found that compared to children who were not exposed to anesthesia, those who were exposed to anesthesia had modest 0.41 percent lower grades. Similarly, those exposed to anesthesia had an approximately 1 percent lower IQ score at age 18 than those not exposed to anesthesia.
To put this into perspective, researchers found that gender and maternal education level had more important effects on grades, each impacting mean grades by approximately 10 percent, than the effect of anesthesia.
Dr. Glatz’s study shows that when a critical surgery is needed in a child, it can be performed before age 4 without a significant decline in cognitive ability at age 16 or 18. This is particularly important for children who may need surgery to prevent problems with hearing or speech, skills that are vital for early development.
Limitations to Dr. Glatz’s study are that other factors, like afterschool tutoring and duration of anesthesia, were not accounted for in the study and may have affected grades between the two groups.
In addition, the findings are primarily for children undergoing a single surgery and those who did not have additional hospitalizations prior to age 16, which may not be the case for all surgeries.
Overall, Dr. Glatz’s study contributes important information when assessing the need for surgery in a child.
Anant Mandawat, a graduate of Lakeside High School and Yale University’s medical school, is a doctor of internal medicine at Massachusetts General Hospital.