by Ron Litman, DO, Medical Director of Institute for Safe Medication Practices
I recently received a call from a father whose four-year-old daughter was scheduled to
receive general anesthesia for a surgical procedure expected to last about two hours. He
was concerned about the risk of exposing her to general anesthesia for that long. “Will it
affect her brain”? “Could there be any long-lasting effects?” These are important
concerns for parents in light of the many recent media reports about possible long-term
harm from exposure to general anesthesia during childhood. Those reports cited two
types of studies: some that purposely exposed animals to large overdoses of anesthesia,
and some that studied large populations of adult humans who were exposed to general
anesthesia during childhood. The results were mixed but nonetheless worrisome. Some
of the animals exposed to general anesthesia developed brain abnormalities if the
exposure occurred before a certain developmental age, and the human studies
demonstrated that if the adults received anesthesia while very young, they were more
likely to have subtle deficits in cognitive function years after the exposure. But these
studies were flawed because the animals received large overdoses in uncontrolled
conditions, and the human studies were performed retrospectively, looking back in time.
For the humans, the researchers were not able to determine whether it was the
anesthesia itself that caused the deficits, or other medical conditions that caused the
subjects to require anesthesia in the first place.