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General Anesthesia Exposure In Infancy Causes Long-Term Memory Deficits
First time accepted submitter LordFlower (606949) writes "In a study, published today in Neuropsycopharmacology, exposure to general anesthesia in both human and rat infants was associated with long-term episodic memory deficits. Children aged 6 to 11 years exposed to general anesthesia during infancy had poorer episodic memory than age/gender matched controls. This deficit was replicated in rats using an analogous paradigm with full experimental control of pre-existing conditions could be exercised, suggesting a causal relation rather than correlational one. Prior research in rats suggests a mechanism of disrupted developmental synaptogenesis and apoptosis.
While a growing literature has demonstrated the presence of memory deficits and neurodegeneration in rats after general anesthesia exposure in infancy, this is the first to demonstrate a long-term deficit after exposure during human infancy. Given that each year 1.5 million infants undergo a surgery requiring general anesthesia, these findings are particularly alarming."
While a growing literature has demonstrated the presence of memory deficits and neurodegeneration in rats after general anesthesia exposure in infancy, this is the first to demonstrate a long-term deficit after exposure during human infancy. Given that each year 1.5 million infants undergo a surgery requiring general anesthesia, these findings are particularly alarming."
Is my infantile general anasthesia experience the reason I can't recite the Hartnell episodes in order?
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This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.
Did they do these studies with one type of anesthesia or many? Were some worse than others? I dread the thought of what we might use as an alternative. A punch in the jaw or a mallet to the top of the head are no longer acceptable.
jenny?
Obviously this extends the need to define not only what differences exist between men and women, but between adults, teens, children and infants for anesthesiology and drug doses.
Uh. What were we talking about again?
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I had an eidetic memory as a kid. Then had to have 3 general anesthesias (broken bones, wisdom tooth extraction (all of them, jaw too small)) before puberty. It was gone afterwards and my school marks dropped from A* to B-D, got better towards the finals). It was terrible hard to remember stuff. Had to train myself for 15 years to regain it.
This flies in the face of current theory, which says infants flush "excess" synapses and children continue to do so on a lesser scale for years. See
Huttenlocher P. Neural Plasticity: The Effects of the Environment on the Development of the Cerebral Cortex. Harvard University Press; 2002.
Or any decent Google search will support this.
Unless a lchemical ink can be shown in the chemistry resultant from the anaesthesia which might cause the synapses to morph, it will be very hard to "prove" this hypothesis.
Correlation does not prove causation.
We've known for decades about the effect that alcohol (one particular CNS depressant) has on brain development. It seems reasonable to assume that other CNS depressants would have the same effect to some degree, at least up to the point where brain cell division stops (several months after birth, IIRC).
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"causal relation as well as correlation". They are not mutually exclusive. On the contrary: the former requires the latter.
Most general anesthetics are fluorine-based. Fluorine is a government-approved neurotoxin. Problem solved.
I wish someone had told me that 53 years ago while on the slab. My surgery wasn't life threatening. 4 surgeries all less than 4yo (1 .lt. 1yo) to fix a crossed eye. Explains a lot actually.
This suffers from heavy selection bias. Children who require general anesthesia in infancy overwhelmingly suffer from congenital malformations which portend a higher rate of subclinical CNS developmental malfunction typically manifesting as mild developmental delay. (I'm a pediatric surgeon).
Reverse anecdote ...
I had tonsillectomy as well, when I was around 5. Yes, in the 1960s it was very common.
But never suffered from memory loss. On the contrary, I was always told I had good memory.
No problem with muscle coordination too
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I call shenanigans. There are approximately 4 million live births in the US annually (http://www.infoplease.com/ipa/A0005067.html). If annually 1.5 million infants underwent a surgery ~ 37% of US live born infants would need a surgery requiring GA in the first year of life. I suspect the 1.5 million is the number of surgeries requiring GA performed on patients under 1 year of age. The trouble is that, as the pediatric surgeon above mentioned, most infants needing surgery in the first year of life have congenital malformations requiring multiple trips to the operating room. So the reality is that some (small) percentage of infants are multiply exposed to GA.
If you want the see the public health side of this problem, don't look at GA and the OR, look at conscious sedation in the ED and acute care setting. When I was in residency we used to push combinations of Ketamine, benzos and opiates in the ED to get kids through orthopedic procedures and laceration repairs all the time. In an average 10 hour shift as the sedationist it would not be unusual for me to perform 10-15 sedations. In reviewing charts before a sedation it would not be unusual to see that a colleague had sedated for a fracture repair a year prior or even a month prior and the kid was back again because of another sports injury or the like. Even if the effect on cognition is minor, spread across the population of all children who ever break a bone or get a nasty cut requiring stitches there is the potential for significant population wide effects.
And particularly for the relatively common case of brain injury (neonatal or otherwise). Infants anesthetization is required for an MRI.
Children with brain injury are certainly much more likely to have deficits like that recorded.
Nobody anesthetizes an infant without a darn good reason.
Who would have guessed that a drug-induced coma, a chemical that literally knocks you the fuck out, would have any kind of long-term effect whatsoever on the brain? Is this seriously news? Did anyone seriously not just kind of figure that such strong drugs for the purpose of suspending the brain would have, you know, mental effects?
I was operated on for a hernia at about 6 weeks of age. In 1954, I would be really surprised if general anesthesia was not administered.
I have no memory problems, as a matter of fact, I am renowned for my ability to remember facts and details. I guess I'm not a rat.
Of course they used as a control a group of children who underwent the procedure without anesthesia?
If Pandora's box is destined to be opened, *I* want to be the one to open it.
But I can't remember if I had anaesthesia as a child.
Some European languages use a cognate of "infant" for much older children. In French, for example, enfant means "child".
How are babies that are born to mothers who receive anesthesia? Does it affect these babies?
Now I know why...
Simplest example: y = x^2. Perfect causation, but do the math and correlation is zero.
That's true if you define correlation to mean only Pearson correlation, for which y=x^2 on an interval symmetric about x=0 exhibits r(x, y)=0. But Pearson correlation is not the only measure of statistical dependence; this article lists other metrics.
I distrust medicine much more than anybody I know. However, our pediatrician scared us into having my kid go through an MRI for a "possibly serious condition" when he was a few months old. Naturally nothing was wrong.
Now he is seven years old... and by fucking golly his memory is scarily good in all situations. My memory is better than at least 99% of adults I meet. The kid puts me to shame. Not only can he easily best me at any memory type of game, his episodic memory is incredible. He'll remember I promised we would do something, recalling every pertinent detail to make sure I adhere to it. He remembers who gave him what toy on which day (I used to remember that stuff when I was a kid). He recalls details of classroom events down to exact phrases.
What I'm trying to say is, as much as I hate medicine in general, I think this is one place at least my kid didn't get messed up by it.