As if Surgery Isn’t Scary Enough

As if Surgery Isn’t Scary Enough

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(Slate) – A worrisome new study caught my eye last week as I perused the website of the journal Pediatrics. It was titled “Cognition and Brain Structure Following Early Childhood Surgery With Anesthesia.” Considering that my now 4-year-old underwent general anesthesia for a minor procedure when he was 2 and that my 14-month-old may be a candidate for ear tube surgery, my interest was immediately piqued.

I clicked through and came face to face with a whole lot of yuck. The first sentence alone made me gasp: “Anesthetics induce widespread cell death, permanent neuronal deletion, and neurocognitive impairment in immature animals, raising substantial concerns about similar effects occurring in young children.” Wait, so anesthesia causes brain damage? Why didn’t anyone tell me? I thought. Obviously, I needed to know more. Considering that 6 million American children—including 1.5 million babies under the age of 1—undergo general anesthesia each year, this seemed like a pretty serious issue to delve into.

Twenty studies and several phone calls later, I’m feeling a lot better about my kids’ brains. There are still many things scientists don’t know about how anesthesia affects the nervous system, in part because they can’t ethically do the types of experiments that would provide clear answers, like unnecessarily exposing kids to anesthesia. But based on the research that does exist, there’s really no need for parents to freak out. If “going under” has an effect on the developing brain, it’s likely to be very small. Even Andreas Loepke, the pediatric anesthesiologist at Cincinnati Children’s Hospital Medical Center who co-authored the Pediatrics paper, was reassuring to me over the phone. “These are theoretical concerns,” he said. Anesthesiologists worry a lot about them because it relates to what they do every day, so if there’s a hint of a potential risk, they want to look into it thoroughly and try to find safer approaches. But nobody thinks that a quick and necessary surgery is going to reduce your child’s IQ by 20 points. (And let me also clarify that the complication rate associated with pediatric anesthesia is extremely low: Fewer than 1 in every 2 million children under the age of 14 dies during surgery as a result of problems related to anesthesia. What I’m talking about here are potential issues that arise after anesthesia.)

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