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. 2017 Dec 19;17(1):170.
doi: 10.1186/s12871-017-0462-8.

Long-duration general anesthesia influences the intelligence of school age children

Qingqing Zhang  1 , Yuanzhi Peng  1 , Yingwei Wang  2
Affiliations

Long-duration general anesthesia influences the intelligence of school age children

Qingqing Zhang et al. BMC Anesthesiol. .

Abstract

Background: General anesthesia has been linked to impaired brain development in immature animals and young children. In this study the influence of orthopedic surgery under general anesthesia on the intelligence of school age children has been evaluated.

Methods: A total of 209 subjects aged 6-12 years were recruited and allocated into 4 groups according to the duration of general anesthesia, including a control group (n = 30), short (< 1 h, n = 49), moderate- (1-3 h, n = 51) and long-duration groups (> 3 h, n = 79), respectively. The intelligence quotient (IQ) of the subjects was measured by the Raven's Standard Progressive Matrices (RSPM) before and after orthopedic surgery under general anesthesia of various durations (vide supra).

Results: The IQ score decreased significantly in the long-duration group at 1 month post-operation compared with the pre-operation score (P < 0.001), and IQ did not recover completely at 3 months postoperatively (P < 0.05), but had recovered when measured at the 1-year follow-up. Moreover, this study showed that the development of children's intelligence was affected by the exposure time to anesthetics at a younger age (OR = 5.26, 95% CI:2.70-8.41, P < 0.001), having a mother with a low education level (OR = 2.71, 95% CI:1.24-6.14, P = 0.014) and premature birth (OR = 2.76, 95% CI:1.34-5.46, P = 0.005).

Conclusions: More than 3 h general anesthesia influenced the IQ of school age children for up to 3 months after orthopedic surgery. Beside extended exposure time to anesthetics additional factors for post-operative IQ reduction were younger children age, mothers with low educational levels and premature birth.

Trial registration: Chinese Clinical Trial Registry with registration number ChiCTR-OOC-17013497 retrospectively registered on 11/23/2017.

Keywords: Children; Cognition; General anesthesia; Intelligence; Orthopedic surgery.

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Conflict of interest statement

Ethics approval and consent to participate

The Ethical Committee of Shanghai Xinhua Hospital approved the study and written informed consents were obtained from all participants’ guardians.

Reference number for the ethics approval is XHEC-D-2009-018.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram of patient enrollment, assignment, follow-up and analysis. A total of 179 subjects were recruited and allocated into various anesthesia exposure groups, namely short-duration (n = 49), moderate-duration (n = 51) and long-duration (n = 79 groups. In addition, 30 subjects served as the control group. Repeated measures analysis of variance (ANOVA) with mixed-effects modeling was used to analyze the differences, including those with incomplete follow-up data
Fig. 2
Fig. 2
Comparison of the median intelligence levels after b) short (group II), c) intermediate (group III) or d) long term (group IV) anesthesia/surgery with a) group I as untreated controls at the indicated times before and after intervention. ***P < 0.001, *P < 0.05
See this image and copyright information in PMC

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