Repeated exposure to anaesthesia link to poorer learning outcomes

Young children who have been exposed to general anaesthesia have a greater risk of poorer development and lower scores in numeracy and reading , particularly if they have more than one surgery with anaesthesia. The study, published in Pediatric Anaesthesia. looked at the outcomes for children that had surgery under the age of four years. shows that children under four years of age exposed to anaesthesia, The study found that the more exposure, the higher the risk, though the risk was low.

The researchers compared the developmental and Year 3 NAPLAN school results of of over 210,000 children in New South Wales children exposed to general anaesthesia during hospital procedures (37,880) up to 48 months of age to same-aged children with no exposure to general anaesthesia or hospitalisation.

Co-author Dr Justin Skowno, a clinical lecturer at the University of Sydney and senior staff specialist in Paediatric Anaesthesia at the Children's Hospital at Westmead said "Determining exactly what is causing this effect is not easy. It could be the surgery, it could be the anaesthetic, or it could be the background medical conditions some of these kids have got. It's a small effect seen over a large number of children,"

"There are some procedures where alternative approaches or management may be possible, but the majority of surgeries in young infants and children cannot easily be postponed." said Dr Skowno "Parents can certainly discuss with their doctor and explore whether these procedures can be avoided, combined with other procedures, delayed to older ages or treated with alternatives to surgery, or other methods of sedation," .

"There are many reasons why a child requires surgery or investigation, and, in some cases, this may be lifesaving or unavoidable," said the study's senior author, Professor Natasha Nassar of the University of Sydney. "For these children, our findings suggest that it is important to follow-up and monitor their literacy and numeracy skills when they reach school, and ensure early intervention, if required."

Compared to children unexposed to general anaesthesia, those exposed to general anaesthesia had a: • 17 per cent increased risk of poor child development • 34 per cent increased risk of lower numeracy scores on school tests • 23 per cent increased risk of lower reading scores on school tests. When the researchers restricted their analyses to children who had only one hospitalisation involving a procedure requiring general anaesthesia, they found no increased risk for poor development or reduced reading scores, however the risk of poor numeracy scores remained.

Further investigation of the specific effects of general anaesthesia on numeracy skills, underlying health conditions that prompt the need for surgery or diagnostic procedures is required, particularly among children exposed to previous or long duration of general anaesthesia or with repeated hospitalisations, the researchers say.

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