• Choon Looi Bong, Duncun Ho, John Carson Allen, Gillian Si-Min Lim, Hong-Kuang Tan, BroekmanBirit F PBFPNeurodevelopment Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research.Department of Psychiatry, Amsterdam UMC and OLVG, VU University Amsterdam, The Netherlands., Teddy Fabila, Satish Reddy, Woon-Puay Koh, Josephine Swee-Kim Tan, Michael Meaney, and Anne Rifkin-Graboi.
• Department of Pediatric Anesthesia, KK Women's and Children's Hospital.
• J Neurosurg Anesthesiol. 2023 Oct 1; 35 (4): 394405394-405.

BackgroundGeneral anesthesia (GA) is known to worsen neural outcomes in animals, but human research assessing early-life GA exposure and neurodevelopment show inconsistent findings. We investigated the effects of a single GA exposure for minor surgery on the neurodevelopment of healthy children at multiple time-points, using clinical assessments along with behavioral and neurophysiological measures rarely used in human research.MethodsGA-exposed children were a prospective cohort of 250 full-term, healthy infants who underwent GA for minor surgery before 15 months. Nonexposed children were from a separate cohort of similar age, sex, ethnicity, and maternal education. In both cohorts, clinical measures (Bayley Scales of Infant and Toddler Development-III [BSID-III] and Child Behavior Checklist [CBCL1½-5]) were assessed at 24 months, and experimental tests (memory and attentional) and neurophysiology (event-related potentials) at 6 and 18 months.ResultsAt 24 months, there were no differences between GA-exposed and nonexposed children in the cognitive, language, motor, and socioemotional domains of the BSDI-III; however, GA-exposed children had poorer parental-reported scores in BSID-III general adaptability (94.2 vs. 99.0 [mean difference, 4.77; 97.3% confidence interval, -9.29, -0.24]; P =0.020) and poorer internalizing behavior scores on CBCL1½-5 (52.8 vs. 49.4 [mean difference, 3.35; 97.3% confidence interval, 0.15-6.55]; P =0.021). For experimental measures, GA-exposed children showed differences in 4 tests at 6 and 18 months.ConclusionsGA-exposed children did not differ from unexposed children in cognitive, language or motor outcomes at 24 months, but exhibited poorer parent-reported behavior scores. Differences in infant behavior and neurophysiology were detected at 6 and 18 months. Neurophysiological assessments may complement clinically relevant assessments to provide greater insights into neurodevelopment following early GA exposure.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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