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Research Letter
October 7, 2019

Trends in Surgery for Children Younger Than 3 Years From 1998 to 2017

Author Affiliations
  • 1UT Southwestern Medical Center, Dallas, Texas
  • 2Children’s Medical Center Dallas, Department of Anesthesiology and Pain Management, Dallas, Texas
  • 3Children’s Medical Center Dallas, Department of Pediatric Critical Care, Dallas, Texas
  • 4UT Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas
  • 5Children’s Medical Center, Dallas, Department of Pediatric Surgery, Dallas, Texas
  • 6Outcomes Research Consortium, Cleveland, Ohio
JAMA Pediatr. Published online October 7, 2019. doi:10.1001/jamapediatrics.2019.3372

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.

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