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Giving anesthesia to newborns is always risky because their immature physiology increases the chance of complications. In addition to the short-term risks, there is growing concern about possible neurotoxic effects on brain development that could cause long-term behavioral and cognitive problems.
Mary Ellen McCann, MD, MPH, is collaborating with researchers in Australia, Europe and the United Kingdom to investigate the long-term effects of two commonly used modes of anesthesia—spinal and general. Newborns undergoing hernia surgery (a common procedure, particularly in premature infants) will be randomly assigned to receive general or spinal anesthesia. They will then undergo developmental testing at age 2 and intelligence testing at age 5 to determine whether there are neurocognitive differences between the groups.
The study will also compare the incidence of apnea (episodes of cessation of breathing) in the two groups of infants, since smaller studies have suggested that there may be less apnea with spinal than with general anesthesia.
McCann hopes the results will enable parents to make a more informed choice about what type of anesthesia their child receives. "Nobody has rigorously looked at this," says McCann. "If it turns out that there is a difference, it would change anesthesia for young infants worldwide."
Ultimately, the team plans to collect data from 660 infants. McCann would like to finish recruiting the U.S. patients within two years, from Children's and nine other centers. She hopes that future studies will then compare the safety of different anesthetic agents.
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