Brief Anesthesia in Infancy Does Not Mar Neurodevelopment
FRIDAY, Feb. 15, 2019 -- Neurodevelopmental outcomes at 5 years of age are equivalent after brief general anesthesia or awake-regional anesthesia in infancy, according to a study published in the Feb. 16 issue of The Lancet.
Mary Ellen McCann, M.D., from Boston Children's Hospital, and colleagues conducted an international randomized trial at 28 hospitals involving infants of less than 60 weeks' postmenstrual age who were born at more than 26 weeks of gestation and were undergoing inguinal herniorrhaphy. A total of 722 infants were randomly assigned to receive awake-regional anesthesia (363 infants) or sevoflurane-based general anesthesia (359 infants).
Primary outcome data on the full-scale intelligence quotient (FSIQ) on the Wechsler Preschool and Primary Scale of Intelligence, third edition, at age 5 years was obtained for 205 children in the awake-regional anesthesia group and 242 in the general anesthesia group. The researchers found that median general anesthesia duration was 54 minutes. The mean FSIQ score was 99.08 and 98.97 in the awake-regional anesthesia and general anesthesia groups, respectively, with a difference in means of 0.23 (95 percent confidence interval, −2.59 to 3.06). Similar results were seen in the intention-to-treat and per-protocol analyses.
"The GAS study provides the strongest evidence to date that a single, brief (less than one hour) exposure to general anesthesia during infancy is not harmful to gross neurodevelopment," write the authors of an accompanying editorial.
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Posted: February 2019