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Long-term neurotoxicity in paediatric patients exposed to general anesthesia

Is there a relationship between exposure to general anesthesia in children between 0 and 4 years of age and the subsequent development of ADHD in childhood?

Published online by Cambridge University Press:  19 July 2023

B. Hernández Gajate ,
T. Gutiérrez Higueras ,
R. M. Fiestas Velasco ,
V. Rubio de la Rubia  and
F. Calera Cortés
B. Hernández Gajate*
Affiliation:
Psychiatry, Hospital Universitario Reina Sofía, Córdoba, Spain
T. Gutiérrez Higueras
Affiliation:
Psychiatry, Hospital Universitario Reina Sofía, Córdoba, Spain
R. M. Fiestas Velasco
Affiliation:
Psychiatry, Hospital Universitario Reina Sofía, Córdoba, Spain
V. Rubio de la Rubia
Affiliation:
Psychiatry, Hospital Universitario Reina Sofía, Córdoba, Spain
F. Calera Cortés
Affiliation:
Psychiatry, Hospital Universitario Reina Sofía, Córdoba, Spain
*
*Corresponding author.

Abstract

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Introduction

The Food and Drug Administration (FDA) recently issued new warnings about the possible effects of the repeated or prolonged use of general anaesthesia and sedatives on the brain development of children under 4 years old during surgeries or paediatric procedures.

Objectives

To evaluate the possible long-term neurotoxic impact the exposure to general anaesthesia has on the paediatric population from 0 to 4 years, which is the period during which the brain develops.

Methods

Initially, a search for observational studies that described the risk of neurotoxicity and alterations in the long-term cognitive development of children exposed to general anaesthesia before 4 years of age, was performed in PubMed between 2016 and 2020.

Results

Finally, 5 retrospective cohort studies comparing children exposed and not exposed to general anaesthesia were included in this study. None of these showed significant differences in their main study variables. However, three of this studies found significant differences in some of the secondary variables such as speed of processing, motor skills, internalization of behaviour and learning, and attention deficit hyperactivity disorder (ADHD).

Conclusions

In vitro and in vivo studies of anesthetics have shown serious neurotoxic effects in the developing brain. However, the clinical relevance of these findings for children undergoing anesthesia remains unclear.

Most of these studies suggest a strong relationship between exposure to anesthesia in children aged 0 to 4 years, this being greater after multiple exposures. Despite these results, many of these articles conclude that further research is needed on this topic.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S145
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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