Anesthesia & Analgesia, September 2014.
Nemergut ME, Crow S, Flick RP
In their study, Williams et al. sought to isolate the effect of surgery from that of general anesthesia by retrospectively comparing the cognitive outcomes of a cohort of infants who had undergone a brief surgical procedure under spinal anesthesia to normative data for the population of Vermont. The authors are to be commended for their contribution in assessing whether a surgical procedure may contribute to adverse cognitive outcome later in childhood. The Pediatric Anesthesia & Neurodevelopment Assessment (Columbia) and Mayo Anesthesia Safety in Kids (Mayo) studies, although not randomized controlled trials, will augment the insights gained from the General Anesthesia Spinal Anesthesia (GAS) study now underway at several U.S. and international sites. None, however, will report definitive outcomes for at least two or three years. In the meantime, we must content ourselves with very important but severely limited studies such as that published by Williams et al. in this issue of Anesthesia & Analgesia. He and his colleagues have provided us with a glimpse at the previously unseen flip side of the anesthesia-surgery coin.
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