Neurodevelopmental outcomes of neonates undergoing surgery under general anesthesia for malrotation of intestines. (June 2017)

• Record Type: Journal Article
• Authors: Birajdar, Suresh; Rao, Shripada; McMichael, Judy
• Is Part Of: Early human development. Volume 109(2017)
• Page Start: 32
• Page End: 36
• Publication Date: 2017-06
• Subjects: UGI upper gastrointestinal -- GA general anesthesia -- GMDS Griffiths mental development scales -- GQ general quotient -- ND neurodevelopment -- SD standard deviation -- MASK Mayo Anesthesia Safety in Kids -- PANDA pediatric anesthesia neurodevelopment assessment -- GAS general anaesthesia and awake-regional anaesthesia in infancy; Newborn infant -- Child developmental disorder -- Surgical procedures -- General anesthesia -- Growth and development -- Learning disorder; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2017.04.003
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: It is difficult to differentiate between the potential adverse effects of general anesthesia (GA) on the developing brain and the role of associated co-morbidities and syndromes that can adversely affect neurodevelopmental outcomes in neonates undergoing GA. Neonates with malrotation of the intestines without volvulus usually do not have co-morbidities or syndromes. In addition, majority of them recover very well after surgery and are discharged home within a few days. Neonates with malrotation are a clean cohort of babies to study the role of a single episode of GA on the developing brain. Aims: The study aimed to evaluate the neurodevelopmental outcomes of neonates undergoing GA for malrotation surgery. Study design: Retrospective review of neonates born at gestational age of ≥ 32 weeks undergoing laparotomy for malrotation. Outcome measures: Neurodevelopment in the study cohort at the age of one year. Results: 33 eligible infants were identified from the departmental database. All 33 survived and were assessed using the Griffiths Mental Development Scales (GMDS) at one year. Mean general quotient (GQ) of the study population was 98 (SD 7.33) which was similar to the population norms (100.2, SD 12.8); p value 0.10. None of the infants developed cerebral palsy, tone abnormality, sensorineural deafness or blindness. There was no significant difference in the centiles at birth versus one year for weight and length (p values 0.454 and 0.178 respectively). Reassuringly, the head circumference centiles at one year showed a trend towards higher values (p value: 0.0735). Conclusion: One year developmental outcomes of neonates undergoing surgery under GA for malrotation were similar to population norms. Highlights: Neurodevelopmental outcomes of neonates undergoing general anesthesia for malrotation surgery were reassuring. Physical growth of these infants at one year was within normal limits. A single, short exposure to general anesthesia appears to be safe in full term or late preterm infants. Animal research suggests that general anesthesia adversely affects developing brain; but evidence in humans is inconclusive.