Key result
Multiple general anesthesia administered before 4 years of age was associated with a greater risk of neurodevelopmental delay compared to unexposed children in 9 out of 10 included studies.
Why the study?
The neurodevelopmental effects of multiple general anesthesia procedures administered in early life remain a critical concern, prompting an FDA alert.
Does multiple general anesthesia increase the risk of neurodevelopmental delay in children under 4 years?
Systematic Review (n=275,786)
Does multiple general anesthesia increase the risk of neurodevelopmental delay in children under 4 years?
Multiple general anesthesia procedures before 4 years of age may be associated with a greater risk of neurodevelopmental delay, warranting careful risk/benefit considerations.
May warrant caution with repeated early anesthesia; supports prospective trials to confirm neurodevelopmental risks.
The effect of multiple general anesthesia (mGA) procedures administered in early life is a critical theme and has led the Food and Drug Administration (FDA) to issue an alert. This systematic review seeks to explore the potential effects on neurodevelopment of mGA on patients under 4 years. The Medline, Embase and Web of Science databases were searched for publications up to 31 March 2021. The databases were searched for publications regarding "children multiple general anesthesia OR pediatric multiple general anesthesia". Case reports, animal studies and expert opinions were excluded. Systematic reviews were not included, but they were screened to identify any possible additional information. A total of 3156 studies were identified. After removing the duplicates, screening the remaining records and analyzing the systematic reviews' bibliography, 10 studies were considered suitable for inclusion. Comprehensively, a total cohort of 264.759 unexposed children and 11.027 exposed children were assessed for neurodevelopmental outcomes. Only one paper did not find any statistically significant difference between exposed and unexposed children in terms of neurodevelopmental alterations. Controlled studies on mGA administered before 4 years of age support that there might be a greater risk of neurodevelopmental delay in children receiving mGA, warranting the need for careful risk/benefit considerations.
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Colletti et al. (2023) conducted a systematic review in Neurodevelopmental delay (n=275,786). Multiple general anesthesia (mGA) vs. Unexposed children was evaluated on Neurodevelopmental alterations or delay. Multiple general anesthesia administered before 4 years of age was associated with a greater risk of neurodevelopmental delay compared to unexposed children in 9 out of 10 included studies.
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