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Review
. 2012 Oct;24(4):376-81.
doi: 10.1097/ANA.0b013e31826a038d.

Pediatric anesthesia and neurodevelopmental impairments: a Bayesian meta-analysis

Charles DiMaggio  1 , Lena S Sun, Caleb Ing, Guohua Li
Affiliations
Review

Pediatric anesthesia and neurodevelopmental impairments: a Bayesian meta-analysis

Charles DiMaggio et al. J Neurosurg Anesthesiol. 2012 Oct.

Abstract

Experimental evidence of anesthesia-induced neurotoxicity has caused serious concern about the long-term effect of commonly used volatile anesthetic agents on young children. Several observational studies based on existing data have been conducted to address this concern with inconsistent results. We conducted a meta-analysis to synthesize the epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children. Using Bayesian meta-analytic approaches, we estimated the synthesized odds ratios (OR) and 95% credible interval (CrI) as well as the predictive distribution of a future study given the synthesized evidence. Data on 7 unadjusted and 6 adjusted measures of association were abstracted from 7 studies. The synthesized OR based on the 7 unadjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.9 (95% CrI, 1.2-3.0). The most likely unadjusted OR from a future study was estimated to be 2.2 (95% CrI, 0.6-6.1). The synthesized OR based on the 6 adjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.4 (95% CrI, 0.9-2.2). The most likely adjusted OR from a future study was estimated to be 1.5 (95% CrI, 0.5-4.0). We conclude that existent epidemiologic evidence suggests a modestly elevated risk of adverse behavioral or developmental outcomes in children who were exposed to anesthesia/surgery during early childhood. The evidence, however, is considerably uncertain.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Funnel Plots, meta-analysis of clinical studies of the association of pediatric anesthesia/surgery with neurodevelopmental pathology (A) unadjusted odds ratios for association of any exposure, (B) adjusted odds ratios for association of any exposure.
Figure 2
Figure 2
Forest Plot, meta-analysis unadjusted odds ratios for association of any exposure to anesthesia/surgery and behavioral or intellectual problems.
Figure 3
Figure 3
Forest Plot, meta-analysis adjusted odds ratios for association of any exposure to anesthesia/surgery and behavioral or intellectual problems.
See this image and copyright information in PMC

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