A child undergoing treatment
The hand of a child, undergoing treatment at a hospital. REUTERS/Navesh Chitrakar

Anaesthesia may impair brain cells in babies and young children. So far scientists are not sure of the specific harm that anaesthesia causes to children. Experiments in young monkeys and other animals have shown that commonly used anesthetics and sedatives can kill brain cells, diminish learning and memory and cause behavior problems. And studies in children have found an association between learning problems and multiple exposures to anesthesia early in life — though not single exposures.

An anesthesia research group, partnering with the Food and Drug Administration, said it’s time for a large study of children younger than 3 to settle the question, Detroit News reported. Meanwhile, surgeons, anesthesiologists and parents should consider carefully how urgent surgery is needed, particularly in children under 3 years of age, concluded a report in The New England Journal of Medicine co-authored by the FDA’s current and former anesthesia chiefs along with doctors in the SmartTots research partnership.

Already, in the vast majority of cases, children that young only undergo surgery if it is medically necessary, not elective. Some operations, such as to correct birth defects, have better outcomes at earlier ages, surgeons recently told the FDA. Millions of kids safely undergo anesthesia. Those drugs have been used for decades so any big risk would likely have been spotted by now. But with animal studies raising the possibility of subtle effects on behavior or learning, this has to be sorted out, a professor of anesthesia at the University of Toronto, said.

If there is a problem with anesthesia, in many cases it may be unavoidable because there are no substitute drugs. In an article published Wednesday in The New England Journal of Medicine, five experts described “a heightened level of concern” about the potential risks, called the data from animal studies “compelling” and said “parents and care providers should be made aware of the potential risks that anesthetics pose to the developing brain.”

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