Table of Contents
Introduction
The term ‘hospital’ itself instills a lot of fear and pain in a child’s mind. However, when an infant might require a surgical procedure that might require anesthesia, it can trouble the parent’s heart as well. While these fears and anxieties are normal, it is important to know how the use of anesthesia can affect a small child. This article will deal with the same.
Is Anesthesia Safe for Babies?
Yes, anesthesia and sedation can be used safely for babies, toddlers, and infants. The advent of pediatric anesthesia has made it possible for children to receive anesthesia without many severe complications. Health care providers called ‘pediatric anesthesiologists’ are trained to give anesthesia, especially to young children. They undergo a year of specialized training to give anesthesia care to children and infants. They enable even the sickest child to undergo life-saving surgeries, leading them to a hopeful and bright future. While like any other medication, there can be some risks associated with the use of anesthesia and sedation. However, pediatric anesthesiologists take all precautions to prevent or minimize these risks.
Does Anesthesia Affect Child Development?
Studies show that a single use of general anesthesia on children less than three years old might not cause severe adverse effects. However, in rare cases, where a recurrent need for general anesthesia is required in an infant less than three years, it may affect their brain development adversely. According to the U.S. Food and Drug Administration (FDA), children below three years of age who receive anesthesia for more than three hours, or might require the use of anesthesia multiple times, have a high risk of being affected.
Fortunately, recent studies have shown that a single brief exposure to anesthesia might not be associated with an adverse effect on the child’s behavior and learning patterns or cause learning disabilities, even in children younger than the age of three years. Studies are not able to reveal any specific anesthetic or sedative agent to be superior or inferior in comparison to each other while used among young children. A study in 2018 published in the Journal of the American Medical Association, Pediatrics showed that children who underwent some kind of surgical procedures that required anesthesia did not have any higher risk or negative impacts on the child’s development when compared to their biological siblings, who did not undergo any procedure requiring anesthesia.
How Does Anesthesia Affect the Brain in an Infant?
Experts are still under research to know the exact effects of anesthesia on the developing brains. As discussed earlier, multiple exposures to the anesthetic or sedative agent can hamper the development of the young brain. On the other hand, a single brief exposure has been found to be relatively safe.
An initiative called SmartTots (Strategies for Mitigating Anesthesia-Related neuroToxicity in Tots) has been organized by the FDA (U.S. Food and Drug Administration). The goal of this initiative is to promote and fund research to make anesthesia and sedation safer for young children and infants, especially those younger than four years. This is mainly because it is a period where a significant amount of brain development occurs. In short, the initiative is in search of safe anesthesia for kids. This research may pave the way for the development of new anesthetic or sedative agents that are very safe to be used even in infants and determine if any of the existing drugs can be potentially harmful to be used in young children. The efforts taken by pediatric anesthesiologists to make anesthesia safe for little children are commendable. However, there is much to be explored in the wide ocean of anesthesia safety, especially for the young ones.
What Are the Long-Term Effects of Anesthesia on Infants?
Healthcare experts have been studying the long-term effects of anesthesia and other sedative agents on infants for over twenty years. Most of the published works of literature show that a short, brief exposure to anesthesia in young children (probably aged three or less) does not have any negative long-term effect on their cognitive abilities. However, children undergoing longer procedures or multiple exposures might have concerns. This can be called neurotoxicity (an adverse effect caused by a physical or chemical agent on the proper functioning of the nervous system).
The drug of choice for anesthesia always depends on the healthcare expert’s best judgment. These warnings do not indicate that anesthesia should never be used in a child younger than three years of age. However, the healthcare professional must weigh the benefits of the proposed surgical procedure and the potential risks associated with anesthesia. If the former weighs more, the procedure can be pushed on, informing the concerned about the potential risks associated with it.
Can There Be Any Change in the Childs Behavior After Anesthesia?
Induction of anesthesia can be a matter of fear for the little mind. Hence, this stress can cause some behavioral changes in the child. However, these are usually short-lived. These changes can be classified as pre-operative anxiety, emergence delirium, and post-operative behavioral changes.
Pre-operative anxiety is normal in any child. Assuring them that everything will be fine and giving them the confidence to face the situation can help them gain mental strength. Emergence delirium is a short-lived state of confusion seen in a child after recovering from anesthesia. It usually resolves within fifteen to thirty minutes. Post-behavioral changes can be due to the memories of fearful incidents, like the parents leaving the child for the procedure, fear of injections, etc. These could be due to the intense fear in the child’s mind of the surgery and other events they would have to face. The most commonly seen negative post-operative behavior changes include nightmares, separation anxiety, sleep disturbance, eating disorders, crying, temper tantrums, and aggression towards authority. However, these are short-lived and can easily be overcome. The love and assurance of the caregivers, and parents, and a special consideration from the hospital staff can do wonders in bringing the child back to their normal being. Empathy and love can, of course, do more wonders than any medicine on this planet! Spending some time with the child, showing them affection, and assuring them that all is fine can help to build confidence in the child and overcome all their fears.
Conclusion
The anesthesiologists usually prefer the safest anesthetic agents for children undergoing surgeries. Studies are ongoing to find out an anesthetic agent that is very safe to be used on infants and young children. Initiatives like SmartTots can be promising and help in foreseeing the advent of safe anesthesia for young children.
