title: Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study.
abstract: OBJECTIVE
  To determine whether perioperative desaturation (PD) in preschool children undergoing non-cardiac surgery is associated with subsequent impairment of intelligence or subsequent change in age-specific weight and height percentile.
  
  
  METHODS
  A historical-concurrent follow-up study was conducted in children aged ≤ 60 months who underwent general anesthesia (GA) for non-cardiac surgery between January 2008 and December 2011 at Songklanagarind Hospital. Children who developed PD (PD group) and children who did not develop perioperative respiratory events (no-PRE group) were matched on sex, age, year of having index GA, type of surgery and choice of anesthesia. The children's age-specific weight and height percentile and intelligence quotient (IQ) scores by Standford Binet-LM or Wechsler Intelligence Scale for Children, 3rd edition 12-60 months after GA were compared using Student's t- test and Wilcoxon's rank sum test. Multivariate linear regression models for standardized IQ and multivariate mixed effects linear regression models for the change of age-specific weight and height percentile from the time of index GA to the time of IQ test were performed to identify independent predictors. The coefficients and 95% confidence intervals (CI) were displayed and considered significant if the F test p-values were < 0.05.
  
  
  RESULTS
  Of 103 subjects in each group (PD vs no-PRE), there were no statistically significant differences in IQ (94.7 vs 98.3, p = 0.13), standardized IQ (-0.1 vs 0.1, p = 0.14) or age-specific weight percentile (38th vs 63th, p = 0.06). However, age-specific height percentile in the PD group at the time of IQ test was significantly lower (38th vs 50th, p = 0.02). In the multivariate analysis, PD was not a significant predictor for standardized IQ (coefficient: -0.06, 95% CI: -0.3, 0.19, p = 0.57), change in age-specific weight percentile (coefficient: 4.66, 95% CI: -2.63, 11.95, p = 0.21) or change in age-specific height percentile (coefficient: -1.65, 95% CI: -9.74, 6.44, p = 0.69) from the time of index GA to the time of IQ test after adjusting for family and anesthesia characteristics.
  
  
  CONCLUSIONS
  Our study could not demonstrate any serious effect of PD on subsequent intelligence or on the change in age-specific weight and height percentile of children after non-cardiac surgery.
authors: Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Maliwan
authors: M
authors: Oofuvong
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Alan Frederick
authors: AF
authors: Geater
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Virasakdi
authors: V
authors: Chongsuvivatwong
authors: Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Thavat
authors: T
authors: Chanchayanon
authors: Division of Child Development, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Juthamas
authors: J
authors: Worachotekamjorn
authors: Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Bussarin
authors: B
authors: Sriyanaluk
authors: Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Boonthida
authors: B
authors: Saefung
authors: Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand.
authors: Kanjana
authors: K
authors: Nuanjun
keywords: Height; Intelligence; Non-cardiac surgery; Pediatric anesthesia; Perioperative desaturation; Weight