Preclinical data demonstrating neuroapoptosis in animals exposed to anesthetics and human data identifying an association between anesthesia and learning deficits1 led to the 2016 US Food and Drug Administration warning that repeated or lengthy anesthetic exposure in children younger than 3 years may affect brain development.2 Recent prospective studies demonstrate no harm from short anesthetic exposure in infants.3 Most anesthetic exposures in young children are under 2 hours.4 Despite these reassuring findings, concerns regarding neurocognitive impairment may lead parents and physicians to defer anesthetic exposure and, thus, surgery. Pediatric surgical epidemiology has been geographically limited without assessment of trends over time. We assessed trends in surgical exposure among children younger than 3 years using a comprehensive national database.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Sanford EL, Sanford NN, Alder A, Szmuk P. Trends in Surgery for Children Younger Than 3 Years From 1998 to 2017. JAMA Pediatr. Published online October 07, 2019. doi:10.1001/jamapediatrics.2019.3372
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: