Learning Disabilities and Anesthesia? Global Fitness

Learning Disabilities and Anesthesia?

Have you heard news reports lately about a study that found that when very young children undergo operations serious enough to require general anesthesia, they are twice as likely to develop learning disabilities as are children who have never been exposed to anesthesia?

At least that’s what the media would have you believe—and you know how the news people love to fan the flames of readers’ panic.

But, please, don’t panic just yet! This latest alarm bell from the media involves a study that appeared in the latest edition (November 2011) of the journal Pediatrics, and was conducted through the Mayo Clinic in Rochester, Minn. The researchers first identified 350 children who had been exposed before the age of 2 at least once to a general anesthetic. Then they looked at the number of learning disabilities (problems with learning math, reading, or writing) in this group of kids during their school years.

Next, the researchers took these 350 children who had received anesthesia before age 2 and compared them with 700 additional children who were from the same school district in Rochester, Minn., but who had not received any anesthesia at a young age. The study found learning disabilities in:

36.6 percent of those with multiple (2 or more) exposures to general anesthesia
23.6 percent of those with a single exposure
21.3 of the children who had never been exposed to anesthesia

In other words, only a minority of children ended up with any learning difficulties, and the percentages of once-exposed and never-exposed children developing learning disabilities later on were roughly the same. A significantly greater number of the children, however, who were exposed at least twice to anesthetics—about 1/3 of this group—developed learning disabilities.

If You Still Find These Findings Frightening . . .

…consider some key points about them:

The study was looking back in time.

That is, the researchers only investigated the medical and school records of children who had been born between 1976 and 1982; thus, it’s important for parents to know that medicine has changed and improved a lot in the past 20-30 years. For example, a gas called halothane was the primary anesthetic agent used back then, but halothane is only rarely used in children nowadays.

The number of exposures to anesthesia made a difference.

Only those children who received 2 or more exposures to anesthesia had a greater-than-normal risk of learning disabilities—and, even then, only about 1/3 of these twice-exposed children were found to have any learning weaknesses.

The ways we monitor patients during operations have greatly improved.

The technologies used to monitor the vital signs (blood pressure, oxygen level, heart rate) of a patient who’s on the operating table have greatly improved since the 1980s. The more precise monitoring machines in use today are able to keep the vital signs from fluctuating widely. This has been a huge step in patient safety, since if anesthetics are not watched constantly, they can cause a patient’s vital signs to fluctuate dangerously.

Healthy children are not given anesthetics.

All the children studied in this analysis were of course very ill, and this means that the researchers could not tell whether the learning disability discovered later was due to the anesthetic used during the operation or to the underlying medical condition of the child. That is, it’s possible that the illness that required the child to have an operation in the first place might have contributed to that child’s learning problems later on. Even the study’s authors admit that it was almost impossible to distinguish the effects of anesthesia from the effects of illness.

This study only applies to general anesthesia.

This is the procedure that renders the patient wholly unconscious. Injections of local anesthetics, which are used to numb a portion of a patient’s skin when treating such things as a cavity in a tooth or a serious cut, have never been linked to learning disabilities.

But neither should we minimize these findings.

I do not mean to diminish the possibly serious implications of this study; in fact, most physicians would agree that the results of this study are sufficiently troubling to warrant more investigation into this issue—and more studies are in fact being launched. Future studies will need to look at the effects of the anesthesia agents currently in frequent use in children.

Most doctors, however, would also agree that the results of this study shouldn’t cause parents to panic if their child has needed or needs an operation. The decision to operate on a child is not taken lightly, and most operations for children under 2 years of age are done in an attempt to save the life of the child. This means that the doctors and surgeons believe that the benefits outweigh the potential risks associated with having an operation.

For more information about this study, visit the American Academy of Pediatrics.