Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood

Mind the Gap Between the Bench and the Bed: The General Anesthetics-Induced Neurotoxicity in the Real World

“…[4][5][6] Even with multiple exposures, the differences are generally very small. Clearly, there is a huge difference between the animal and human studies designs.…”

Does General Anesthesia Have Detrimental Effects on Immature Human Brain?

“…The PANDA (Pediatric Anesthesia and Neurodevelopment Assessment) Study (38,39) This is a multicentre ambidirectional siblingmatched cohort trial which conducted between May 2009 and April 2015 at 4 university-based US pediatric tertiary care hospitals. The study enrolled 105 biologically related siblings, one of which received inhaled general anesthesia for herniorrhaphy before age of 3 years.…”

“…There was also no significant difference in mean scores of all the secondary outcomes. The authors concluded that among healthy children with a single anesthesia exposure under age 3 does not result in cognitive deficits (38). The sibling-matched design minimized the influences of genetic background, familial environment, parental education, and other indexes of socioeconomic status, all key factors affecting neurodevelopment.…”

Response to the Food and Drug Administration warning on the use of anaesthetics in young children

“…9,10 Recently, however, more robust human studies have been published such as General Anaesthesia compared to Spinal anaesthesia (GAS) study 11 and Pediatric Anesthesia NeuroDevelopment Assessment (PANDA). 12,13 The GAS study, which compares children less than 60 weeks' post-gestational age (but older than 26 weeks' post gestation) undergoing hernia surgery under either general anaesthesia or awake regional anaesthesia, has shown that at the 2-year mark (secondary outcome), there is no increase in risk of learning disability. This study is ongoing with its primary outcome being the Wechsler Preschool and Primary Scale of Intelligence Third Edition Full Scale Intelligence Quotient score at 5 years old.…”