Neurodevelopmental outcomes in infants undergoing general anesthesia.
OBJECTIVE
Preclinical data strongly suggest that all agents used for general anesthesia (GA) have detrimental effects on the developing brain. However, clinical data are unclear. The purpose of this study was to use a cohort of infants who underwent GA and understand their neurodevelopmental outcomes.


METHODS
A cohort of infants who underwent GA was selected between 2010 and 2011, and a control group was created. Data regarding GA, procedures, and outcomes were collected in 2015. The cohort was divided into controls, GA without surgery, GA and surgery once, and multiple general anesthetics. Both univariate and multivariate analysis were performed, and a p value of less than 0.05 was considered significant.


RESULTS
457 patients, 121 controls, and 336 cases were included. Median follow-up was 5.1years. While developmental delay and the need for speech therapy were higher with GA, this did not correlate with the duration of GA. Patients having GA for MRI had the poorest outcomes. Multivariate analysis using combined binary outcome measures for psychiatric and neurologic outcomes did not show any significant difference for duration of anesthesia, age at anesthesia, or induction and maintenance agents.


CONCLUSIONS
These data suggest that GA during the first year of life may have few significant neurodevelopmental effects compared to controls. Additionally, the duration of GA did not correlate with neurodevelopmental outcomes.


METHODS
Retrospective Case Control Cohort Study.


METHODS
3 b (according to Oxford Center for EBM Levels of Evidence, March 2009, http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/).
University of Florida College of Medicine, Department of Surgery.
Kelsey A
KA
Nestor
University of Florida College of Medicine, Department of Surgery.
Michelle
M
Zeidan
University of Florida College of Medicine, Department of Surgery.
Erin
E
Boncore
University of Florida College of Medicine, Department of Surgery.
Aaron
A
Richardson
University of Florida College of Medicine, Department of Anesthesia.
Gijo
G
Alex
University of Florida College of Medicine, Department of Pediatrics.
Michael
M
Weiss
University of Florida College of Medicine, Department of Surgery. Electronic address: Saleem.islam@surgery.ufl.edu.
Saleem
S
Islam
D000768:Anesthesia, General / Q000009:adverse effects*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors
General anesthesia; Infants; Neonates; Neurodevelopmental outcomes