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Babies and toddlers who had anaesthesia during surgery ended up having slightly worse scores on language and reasoning tests as 10-year-olds, in a new study.
"At this point, we're still unsure if these differences are due to anaesthesia, surgery or some other factor, like the underlying diagnosis that caused kids to need surgery in the first place," said lead researcher Dr Caleb Ing from Columbia University in New York.
Even if anaesthesia proves to be behind the extra risk of learning problems, it's still important for many surgeries in kids, researchers said.
"The vast majority of procedures we do on kids of this age, we don't do lightly," said Dr David Warner, an anaesthesiologist from the Mayo Clinic in Rochester, Minnesota.
Surgeries to relieve inner ear pressure, hernia procedures, circumcisions and tonsillectomies were the most common reasons kids in the new study received anaesthesia.
The data was collected from records of about 2600 kids born in Australia between 1989 and 1992. Of those, 321 went under anaesthesia at least once before age three.
At age 10, all kids in the study were given a battery of tests measuring their thinking, language and motor skills as well as behaviour issues.
Clinically significant
There were no differences in behavioural problems or motor function based on whether or not kids had needed anaesthesia as babies and toddlers, according to findings published in the Pediatrics.
But kids who'd had anaesthesia were about twice as likely to show signs of language disabilities and 70% more likely to have reasoning problems than the non-anaesthesia group.
The researchers counted a "disability" as a score in the seventh percentile or lower on the standardised tests.
It's difficult to say if the average difference in learning and reasoning between the two groups is one that a parent or teacher would notice in the average child, Dr Warner said.
Still, he added that combined with other research linking multiple rounds of anaesthesia with learning disabilities and attention-deficit hyperactivity disorder, the effect "may in fact be clinically significant."
What this study adds, Dr Warner pointed out, is that even kids who underwent anaesthesia only once when they were very young still had more trouble later on.
Nonetheless, "Our results do not mean that children should not have surgery if it's needed," Dr Ing explained.
Increased risk but no problems
Dr Warner, who wasn't involved in the new study, agreed. "Even though there is an increase in risk, the vast majority of kids don't have problems (after anaesthesia)," he said.
For example, 30 out of 214 kids who'd gone under anaesthesia had very low scores on the language test.
"We don't want parents to be unduly alarmed, to prevent their children from having necessary surgery. But we can't be entirely reassuring that there aren't any long-term effects, especially from having multiple anaesthetics," Dr Warner said.
Dr Ing said studies currently underway are testing whether there's a difference in the long-term effects of local and general anaesthesia.
But for now, he added, "We don't have enough evidence to change our current medical practice."
(Reuters Health, August 2012)
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