Temporary Disabled. :) please Go back Anesthesia and Children « Your Children's Health www.fgks.org » Address: [go: up one dir, main page] Include Form Remove Scripts Accept Cookies Show Images Show Referer Rotate13 Base64 Strip Meta Strip Title Session Cookies This page requires javascript WebMD Home WebMD Community: Expert Blogs Your Children's Health Print Article WebMD Expert Blogs Your Children's Health Being a parent may be the most rewarding experience in the world, but it's also a challenge. WebMD's experts talk about the job of raising kids - from diapers to dorm room. Thursday, October 13, 2011 Anesthesia and Children By Roy Benaroch, MD A new study gives parents of children something new to worry about. As summarized here on WebMD, there may be a link between general anesthesia and developmental problems in children, especially those undergoing multiple surgeries prior to age 2. Though the study raises some important questions, significant shortcomings in the study itself mean that we don’t have a clear answer, yet, on whether the risk is real, or how big the risk is likely to be. For surgical procedures, several “levels” of anesthesia are available. The simplest involves injecting local anesthetics into the body, similar to what dentists routinely use to perform fillings. Sometimes, these anesthetics are used in a “regional block” can be used to numb an entire limb or body area. More intense anesthesia than this usually requires intravenous medications. In “conscious sedation,” often used in emergency rooms for procedures, enough anesthetic is given to help a patient sleep through a procedure even while continuing to breathe on his own. The most-intense, high-tech form of anesthesia is called “general anesthesia,” during which a patient is completely snowed by medicines that cause complete unconsciousness and muscle paralysis. This kind of anesthesia is necessary for the most invasive surgical procedures. Could this level of anesthesia cause problems with the developing brain? The recent study reviewed a group of 8,500 children born between 1976 and 1982. About 350 of the kids had undergone one surgical procedure, and 70 had more than one. The researchers administered tests of intellectual ability and school acheivement, comparing the children who had had surgery to those who didn’t. They found that children who had undergone anesthesia two or more times had about twice the risk of learning difficulties, compared to children who had never had surgery. The good news: There was no increased risk observed after one surgical procedure. Several shortcomings of the study are worth thinking about: These surgical procedures took place in the 1970s and 1980s, before the use of many technological monitoring devices such as pulse oximeters. Also, anesthetic drugs used then are not the same as those used now. It’s impossible to tell from this kind of study if the increased risk was from the surgery, the anesthesia, or both. Though the authors tried to control for underlying health issues, it is difficult in retrospect to be sure that the children (especially those who needed more than one surgery) didn’t have other health problems that could have led to developmental problems. Perhaps it wasn’t the anesthesia that caused the problem, but the underlying health issues that led to the need for surgery that contributed to learning issues later. If your young child has been recommended to have surgery, you may want to think about some questions that could make anesthesia safer: Is the surgery necessary? Watchful waiting is sometimes an option. Can the surgery be delayed? Studies in animals and humans show the greatest risk for brain injury to be in the youngest children. Surgery after 6 months is better than surgery at birth; surgery at 2 years is even better yet. Can the surgery be done safely without general anesthesia? Sometimes regional blocks or other kinds of anesthesia are good options. If surgery is necessary, it ought to be done at a center that has a lot of pediatric experience, pediatric equipment, and pediatric nurses and anesthesiologists. We’re fortunate to live in a world where deadly problems can be addressed surgically, even in the youngest children. But we still need to be careful. Posted by: Roy Benaroch, MD, FAAP at 8:45 am Link to this post Comments Leave a comment WebMD Community HomeWebMD Parenting CommunitySee All Blogs See All Health Experts Roy Benaroch, MD Dr. Roy Benaroch is a general pediatrician, author, and educator at Emory University. He has written two books for parents and contributes to several parenting and medical web sites and print journals.Is also an expert in the following:WebMD® Parenting Community Recent Posts Anesthesia and Children Simple Steps Can Prevent Medical Errors Why Kids Are Safer in Grandma’s Car Teens and “Catch Up” Sleep: What Are the Risks? Who Decides Your Doctor’s Salary? Teaching Healthy Habits We Need A Better Flu Vaccine Say It Ain’t So, SpongeBob! Kids and Weight: The New Taboo? Health Care Reform, Simplified Subscribe & Stay Informed Get the 'Your Children's Health' feed Parenting and Children's Health Get the Parenting & Children's Health newsletter and get useful parenting tips and health news you need to keep your little ones happy & healthy. 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Being a parent may be the most rewarding experience in the world, but it's also a challenge. WebMD's experts talk about the job of raising kids - from diapers to dorm room.
By Roy Benaroch, MD
A new study gives parents of children something new to worry about. As summarized here on WebMD, there may be a link between general anesthesia and developmental problems in children, especially those undergoing multiple surgeries prior to age 2. Though the study raises some important questions, significant shortcomings in the study itself mean that we don’t have a clear answer, yet, on whether the risk is real, or how big the risk is likely to be.
For surgical procedures, several “levels” of anesthesia are available. The simplest involves injecting local anesthetics into the body, similar to what dentists routinely use to perform fillings. Sometimes, these anesthetics are used in a “regional block” can be used to numb an entire limb or body area. More intense anesthesia than this usually requires intravenous medications. In “conscious sedation,” often used in emergency rooms for procedures, enough anesthetic is given to help a patient sleep through a procedure even while continuing to breathe on his own. The most-intense, high-tech form of anesthesia is called “general anesthesia,” during which a patient is completely snowed by medicines that cause complete unconsciousness and muscle paralysis. This kind of anesthesia is necessary for the most invasive surgical procedures. Could this level of anesthesia cause problems with the developing brain?
The recent study reviewed a group of 8,500 children born between 1976 and 1982. About 350 of the kids had undergone one surgical procedure, and 70 had more than one. The researchers administered tests of intellectual ability and school acheivement, comparing the children who had had surgery to those who didn’t. They found that children who had undergone anesthesia two or more times had about twice the risk of learning difficulties, compared to children who had never had surgery. The good news: There was no increased risk observed after one surgical procedure.
Several shortcomings of the study are worth thinking about:
If your young child has been recommended to have surgery, you may want to think about some questions that could make anesthesia safer:
If surgery is necessary, it ought to be done at a center that has a lot of pediatric experience, pediatric equipment, and pediatric nurses and anesthesiologists. We’re fortunate to live in a world where deadly problems can be addressed surgically, even in the youngest children. But we still need to be careful.
Posted by: Roy Benaroch, MD, FAAP at 8:45 am
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