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A new study identifies a side effect of an effort to save a young life. The study examines very young children who've had surgery multiple times with general anesthesia. Scientists at the Mayo Clinic say those children fact greater risk of developing learning disabilities. Here's NPR's Joseph Shapiro.
JOSEPH SHAPIRO: There'd been an earlier study six years ago that found exposure to anesthesia at a very young age can kill off brain cells. But that was a study of baby rats. Robert Wilder, a pediatric anesthesiologist, was skeptical.
Dr. ROBERT WILDER (Pediatric anesthesiologist): The initial reaction of the pediatric anesthesia community was: this must be wrong, we've been giving anesthetics to kids for years and we don't see a big problem.
SHAPIRO: Still, Dr. Wilder wanted to check. He works at the Mayo Clinic. And because the famous medical center is in Rochester, Minnesota, the county around it has kept precise records on the health care of its residents. So, Wilder got data from more than 5,000 children. He compared the 600 of them who, before they'd even turned four, had one or more surgeries with a general anesthesia. That's anesthesia that enter the blood stream, reaches the brain and leaves a patient in a state of unconsciousness, not anesthesia that just dulls feeling in one part of the body.
The surgeries ranged from the serious, like open heart surgery, to more routine ones, like putting in ear tubes or removing adenoids and tonsils. Most of the kids in the study — about 80 percent — had surgeries for the small and common problems.
Dr. WILDER: What we found was that children who had a single anesthetic, their incidents of learning disability was exactly equal to the general population.
SHAPIRO: But kids who'd had two surgeries were one and a half times more at risk. Three operations and the risk went up to two and a half times. In that county in Minnesota 50 percent of kids who'd had three or more operation were later found in school to have a learning disability.
That link between anesthesia and learning disabilities makes sense to Amanda Rathbun, who lives outside Salt Lake City.
Ms. AMADA RATHBUN: I always thought that things like this ran in families, like if your dad has brown eyes, then you're more likely to have brown eyes. But there's not a history of this in our family.
SHAPIRO: Rathbun's got three very smart kids. Her 11-year-old daughter has no learning disability. But another daughter, who's eight, and her son, who's 13, each had several surgeries soon after birth. They both have been diagnosed with attention deficit disorder. And the son struggles to write legibly. Fine motor skills are a problem, and Rathbun wonders if he could have gotten more attention for that sooner.
Ms. RATHBUN: If general anesthesia early in life can really cause these sorts of problems, I think it would be good to know that, because maybe we could start more early intervention services for these kids and maybe prevent some of these later problems.
SHAPIRO: The new research is published in the current issue of the journal Anesthesiology. The co-authors are clear that more studies are needed to say for sure it's the anesthesia that causes the problem. It might be the illness that requires the surgery — although the researchers took the sickest children out of the study.
Dr. Piyush Patel, a professor of anesthesiology at the University of California San Diego wrote an editorial in the same journal. He says parents shouldn't avoid surgery when kids need it, but they can check whether it's possible to postpone a surgery until a child is older.
Dr. PIYUSH PATEL (Professor of anesthesiology, University of California San Diego): Based on these data, the parents of children have to be comfortable that the surgery is absolutely needed and they have to balance the risk of waiting for the surgery to be done versus the complication that may arise. And this is a decision that is best made by the surgeon and the anesthesiologist.
SHAPIRO: To further settle some of these questions the federal Food and Drug Administration earlier this month announced plans for more research.
Joseph Shapiro, NPR News.
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