Data gathered from the original Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) trial provided a unique, optimal opportunity to examine the long-term effects of multiple exposures to general anaesthesia in a randomised controlled trial setting.  The ACFBAL trial, begun in 1999, randomly assigned infants with Cystic Fibrosis to either repeated bronchoalveolar-lavage (BAL)-directed therapy with general anaesthesia or standard care with no planned lavages up to 5 years of age when all children received BAL-directed therapy under general anaesthesia.  The extension study, entitled CF-GAIN, used the ACFBAL cohort of children to determine if a greater number of general anaesthesia exposures in early childhood is associated with a different neurodevelopmental or brain MRI outcome compared with fewer general anaesthesia exposures.  From 2013 – 2017, CF-GAIN researchers administered a battery of child and parent measurements to the cohort to assess a range of primary and secondary outcomes.

While the study had several limitations, the findings suggest that repeated general anaesthesia exposure in young children with cystic fibrosis is not related to functional impairment in attention, intellectual quotient, executive function, or brain structure compared with a group with fewer and shorter cumulative anaesthesia durations.  The study authors concluded that neither a single nor repeated brief exposures to general anaesthesia in young children is likely to be associated with poorer neurodevelopmental outcomes compared with no or fewer exposures.

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Claire Elizabeth Wainwright, et al.
The Lancet June 2024