Are Anesthesia and Surgery during Infancy Associated with Altered Academic Performance during Childhood?

Although studies in neonatal animals show that anesthetics have neurotoxic effects, relevant human evidence is limited. We examined whether children who had surgery during infancy showed deficits in academic achievement. We attempted to contact parents of 577 children who, during infancy, had one of...

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Veröffentlicht in:Anesthesiology (Philadelphia) 2012-09, Vol.117 (3), p.494-503
Hauptverfasser: BLOCK, Robert I, THOMAS, Joss J, BAYMAN, Emine O, CHOI, James Y, KIMBLE, Karolie K, TODD, Michael M
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container_issue 3
container_start_page 494
container_title Anesthesiology (Philadelphia)
container_volume 117
creator BLOCK, Robert I
THOMAS, Joss J
BAYMAN, Emine O
CHOI, James Y
KIMBLE, Karolie K
TODD, Michael M
description Although studies in neonatal animals show that anesthetics have neurotoxic effects, relevant human evidence is limited. We examined whether children who had surgery during infancy showed deficits in academic achievement. We attempted to contact parents of 577 children who, during infancy, had one of three operations typically performed in otherwise healthy children. We compared scores on academic achievement tests with population norms. Composite scores were available for 287 patients. The mean normal curve equivalent score was 43.0±22.4 (mean±SD), lower than the expected normative value of 50, P
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We examined whether children who had surgery during infancy showed deficits in academic achievement. We attempted to contact parents of 577 children who, during infancy, had one of three operations typically performed in otherwise healthy children. We compared scores on academic achievement tests with population norms. Composite scores were available for 287 patients. The mean normal curve equivalent score was 43.0±22.4 (mean±SD), lower than the expected normative value of 50, P&lt;0.0001 by one-sample Student t test; and 35 (12%) had scores below the 5th percentile, more than expected, P&lt;0.00001 by binomial test. Of 133 patients who consented to participate so that their scores could be examined in relation to their medical records, the mean score was 45.9±22.9, P=0.0411; and 15 (11%) scored below the 5th percentile, P=0.0039. Of 58 patients whose medical records showed no central nervous system problems/potential risk factors during infancy, 8 (14%) scored below the 5th percentile, P=0.008; however, the mean score, 47.6±23.4, was not significantly lower than expected, P=0.441. Duration of anesthesia and surgery correlated negatively with scores (r=-0.34, N=58, P=0.0101). Although the findings are consistent with possible adverse effects of anesthesia and surgery during infancy on subsequent academic achievement, other explanations are possible and further investigations are needed.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/ALN.0b013e3182644684</identifier><identifier>PMID: 22801049</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams &amp; Wilkins</publisher><subject>Achievement ; Adolescent ; Anesthesia ; Anesthesia - adverse effects ; Anesthesia. 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We examined whether children who had surgery during infancy showed deficits in academic achievement. We attempted to contact parents of 577 children who, during infancy, had one of three operations typically performed in otherwise healthy children. We compared scores on academic achievement tests with population norms. Composite scores were available for 287 patients. The mean normal curve equivalent score was 43.0±22.4 (mean±SD), lower than the expected normative value of 50, P&lt;0.0001 by one-sample Student t test; and 35 (12%) had scores below the 5th percentile, more than expected, P&lt;0.00001 by binomial test. Of 133 patients who consented to participate so that their scores could be examined in relation to their medical records, the mean score was 45.9±22.9, P=0.0411; and 15 (11%) scored below the 5th percentile, P=0.0039. Of 58 patients whose medical records showed no central nervous system problems/potential risk factors during infancy, 8 (14%) scored below the 5th percentile, P=0.008; however, the mean score, 47.6±23.4, was not significantly lower than expected, P=0.441. Duration of anesthesia and surgery correlated negatively with scores (r=-0.34, N=58, P=0.0101). Although the findings are consistent with possible adverse effects of anesthesia and surgery during infancy on subsequent academic achievement, other explanations are possible and further investigations are needed.</description><subject>Achievement</subject><subject>Adolescent</subject><subject>Anesthesia</subject><subject>Anesthesia - adverse effects</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Central Nervous System Diseases - etiology</topic><topic>Child</topic><topic>Humans</topic><topic>Infant</topic><topic>Medical sciences</topic><topic>Risk Factors</topic><topic>Surgical Procedures, Operative - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BLOCK, Robert I</creatorcontrib><creatorcontrib>THOMAS, Joss J</creatorcontrib><creatorcontrib>BAYMAN, Emine O</creatorcontrib><creatorcontrib>CHOI, James Y</creatorcontrib><creatorcontrib>KIMBLE, Karolie K</creatorcontrib><creatorcontrib>TODD, Michael M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BLOCK, Robert I</au><au>THOMAS, Joss J</au><au>BAYMAN, Emine O</au><au>CHOI, James Y</au><au>KIMBLE, Karolie K</au><au>TODD, Michael M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are Anesthesia and Surgery during Infancy Associated with Altered Academic Performance during Childhood?</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>117</volume><issue>3</issue><spage>494</spage><epage>503</epage><pages>494-503</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>Although studies in neonatal animals show that anesthetics have neurotoxic effects, relevant human evidence is limited. 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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete
subjects Achievement
Adolescent
Anesthesia
Anesthesia - adverse effects
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Central Nervous System Diseases - etiology
Child
Humans
Infant
Medical sciences
Risk Factors
Surgical Procedures, Operative - adverse effects
title Are Anesthesia and Surgery during Infancy Associated with Altered Academic Performance during Childhood?
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