Pediatric anesthesia and neurodevelopmental impairments: a Bayesian meta-analysis

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

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.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Anesthesia / adverse effects*
  • Bayes Theorem
  • Child
  • Child, Preschool
  • Developmental Disabilities / chemically induced*
  • Developmental Disabilities / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Monte Carlo Method
  • Nervous System / growth & development*
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / epidemiology
  • Sample Size
  • Software