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Is Anesthesia Safe For Children? (Updated)

This is an updated version of an anesthesia safety blog post originally published by Dr. Dean Andropolous on March 21, 2011.

As the Chief of Anesthesiology at Texas Children’s Hospital, I am well aware of the raised public awareness about the possible effects of anesthesia on childhood neurological development, including recent news stories on CNN and the Wall Street Journal about a research study just published by the American Academy of Pediatrics in the journal Pediatrics. I believe it is important for all parents to understand the facts around this issue so that you can feel confident about entrusting your children to our care. I think it is very important to note that this study just published is a re-analysis of previous research, in a slightly different way, of a group of patients receiving anesthesia many years ago, 1976-82, at the Mayo Clinic. Their results and conclusions are very similar to their previously published studies, that patients receiving anesthesia and surgery more than once at age 2 years or less, have an increased incidence of learning disabilities later in school. Conditions during anesthesia and surgery have changed dramatically over the past 30 years, and it is not clear that these results apply to our patients today at Texas Children’s Hospital. In the near future, we will be launching a very important research study, called the TEXANS Study, for TEXas Anesthesia and Neurodevelopment Study. If your child had anesthesia at Texas Children's Hospital from 2001-2010 at age 3 years or less, they may be eligible for the study. If eligible, your child would be invited at age 6-12 years for a complete, free, neurodevelopmental evaluation to see if anesthesia and surgery have any effects. We believe we have a much better research design, and that because we are studying modern anesthesia techniques, we will have a better answer to the question. In the meantime, we are not recommending any changes to current practice of pediatric anesthesia, and the U.S. Food and Drug Administration, the SmartTots organization, and experts in this area of research, all agree. I will be giving a major address at the American Society of Anesthesiologists’ Annual Meeting later this month that emphasizes this point, that current practices should not change, and that the benefit of much needed surgery and anesthesia at a young age far outweigh any theoretical risk of the anesthesia drugs. The question of anesthetic effect on neurodevelopment has been raised more and more frequently over the past few years. To answer this, two recent studies have been conducted, including one at our Texas Children’s Heart Center, to learn more about this issue.

We found that the amount of anesthesia and sedation received in the perioperative period for congenital heart surgery in neonates DOES NOT affect neurological outcomes (based on testing at 12-24 months of age). Two additional studies are currently underway as well. At Texas Children’s, over 35,000 patients undergo anesthesia and sedation every year. Our practice has been and always will be to treat each child as an individual, and to give that child the right anesthesia drugs and doses, to ensure safe and successful completion of the surgery. Because children are so small, we have specially-trained staff dedicated to anesthetizing children — and significant complications are very rare. If you’re interested in learning more details, I encourage you to visit the Smart Tots website. You can also ask a question below and I will answer them as best I can. Please know that nothing is more important to Texas Children’s Hospital than the safety and health of the children it is our privilege to treat every day. We also believe it is important to have an open and honest dialogue with our families and I hope this blog entry will help foster such a conversation.