Joint guidance on general anaesthesia in young children

Following reports emerging of possible effects of anaesthesia on the developing brain, new professional joint guidance has been released by the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI), Royal College of Anaesthetists, Association of Anaesthetists of Great Britain and Ireland, and the College of Anaesthetists of Ireland on the use of general anaesthesia in young children.

Below are the key points from the guidance: 

  • Studies on immature animals have demonstrated that general anaesthetic agents can induce changes in the central nervous system. Some of these studies have also suggested longer-term effects on learning and memory tests. 
  • To date the results from both epidemiological studies and prospective trials in the human infant have failed to show adverse effects on cognitive development from a single anaesthetic episode of short duration (less than an hour). Data from longer exposures and multiple exposures to surgery and anaesthesia are difficult to interpret due to multiple confounding variables.
  • Continuing to use reliable familiar techniques for paediatric anaesthesia is emphasised. There is no evidence of a particular anaesthetic technique being better than another in terms of influencing any potential long-term neurological effects.
  • Parents/ carers enquiring about the neurological effects of anaesthesia in their infant should be advised that surgery is carried out in infants only when necessary and that currently there is no indication of a long-term neurological effect from a single anaesthesia exposure. They should be referred to the current advice to parents on the APAGBI website.
  • At this time, discussion of the potential influence of infant anaesthesia on long term cognitive development is not regarded as mandatory at every preoperative consultation.

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