Clinical Meeting Summary
Clinical studies, in general, have shown that brief single anesthetic exposures are not associated with adverse outcomes in neurodevelopment. In contrast, studies examining effects of repeated or longer-term exposures have generally found an association with longer term problems, including increased diagnosis of learning disorders, ADHD, and problems with reading and executive function. Children exposed to surgery and anesthesia may well be different pre-exposure, and the experience of surgery and anesthesia, including pain, stress, inflammation, and other factors may have unique effects on longer term outcomes. Important questions still remain regarding the potential adverse long-term neurodevelopmental effects of prolonged, or repeated exposures to anesthetic and sedative agents in the operating room, the ICU, and elsewhere, particularly in children with pre-existing medical and neurological vulnerabilities.
The group discussed several possible approaches to study long duration or repeated anesthetic doses. Additional work is needed to explore designs for clinical trials or other studies that will minimize or eliminate potential confounders.