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Medicine

General Anesthesia Exposure In Infancy Causes Long-Term Memory Deficits 90

First time accepted submitter LordFlower (606949) writes "In a study, published today in Neuropsycopharmacology, exposure to general anesthesia in both human and rat infants was associated with long-term episodic memory deficits. Children aged 6 to 11 years exposed to general anesthesia during infancy had poorer episodic memory than age/gender matched controls. This deficit was replicated in rats using an analogous paradigm with full experimental control of pre-existing conditions could be exercised, suggesting a causal relation rather than correlational one. Prior research in rats suggests a mechanism of disrupted developmental synaptogenesis and apoptosis.

While a growing literature has demonstrated the presence of memory deficits and neurodegeneration in rats after general anesthesia exposure in infancy, this is the first to demonstrate a long-term deficit after exposure during human infancy. Given that each year 1.5 million infants undergo a surgery requiring general anesthesia, these findings are particularly alarming."
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General Anesthesia Exposure In Infancy Causes Long-Term Memory Deficits

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  • Is my infantile general anasthesia experience the reason I can't recite the Hartnell episodes in order?

  • by peter303 ( 12292 ) on Monday June 09, 2014 @07:30PM (#47198887)
    This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.
    • by Anonymous Coward

      This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.

      It also apparently messes up memory.

      So how do you know you remember having better coordination?

    • by Trogre ( 513942 )

      There could be a relationship there.

      More likely though is that children grow in bursts and you may have had such a growth spurt coincide with the surgery. Children who have become accustomed to their bodies having certain parameters (height, mass, limb length, etc), can and do often appear clumsy and less coordinated overall for a period when these parameters suddenly change. Although I suspect this is more evident in teenagers.

    • Reverse anecdote ...

      I had tonsillectomy as well, when I was around 5. Yes, in the 1960s it was very common.

      But never suffered from memory loss. On the contrary, I was always told I had good memory.

      No problem with muscle coordination too

    • Is this getting modded up because it's so stupid? I'm missing my mod points for today or I'd vote it down.

    • This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.

      I misread the headline. I thought that it was infantry, as opposed to infancy. I betcha both are true.

  • Did they do these studies with one type of anesthesia or many? Were some worse than others? I dread the thought of what we might use as an alternative. A punch in the jaw or a mallet to the top of the head are no longer acceptable.
    • by Hognoxious ( 631665 ) on Monday June 09, 2014 @08:22PM (#47199189) Homepage Journal

      Do the surgery without aesthetics. Then they'll wish they had a poor memory.

      • I'd rather the surgeon was calmed by the appearance of the operating theater. I don't see how deliberately making it ugly would improve the situation.
      • Circumcision is typically done without anesthetics.

      • I know you were making a joke, but before 1986 surgery (including major surgery) on infants was routinely performed without anaesthesia (they used a paralytic to keep the infant still), as it was thought that anaesthetic were harmful to infants and infants did not have a fully developed nervous system necessary to feel pain. For the same reasons infants and children were denied pain medication.
        Turns out that not only do infants feel pain like adults, but they still felt the pain from surgery as adults. The
      • by Cyfun ( 667564 )

        Fairly confident most babies don't have plastic surgery done, so there's no cause for concern.

  • by BoRegardless ( 721219 ) on Monday June 09, 2014 @07:43PM (#47198943)

    Obviously this extends the need to define not only what differences exist between men and women, but between adults, teens, children and infants for anesthesiology and drug doses.

  • by Chas ( 5144 )

    Uh. What were we talking about again?

    Oh! Hi! What's your name?

  • This flies in the face of current theory, which says infants flush "excess" synapses and children continue to do so on a lesser scale for years. See

    Huttenlocher P. Neural Plasticity: The Effects of the Environment on the Development of the Cerebral Cortex. Harvard University Press; 2002.

    Or any decent Google search will support this.

    Unless a lchemical ink can be shown in the chemistry resultant from the anaesthesia which might cause the synapses to morph, it will be very hard to "prove" this hypothesis.

    Corr

    • by geekoid ( 135745 )

      NO, it dis not fly in the face of the current theory, and it's "Correlation does not imply causation".

    • by Anonymous Coward

      http://scholar.google.com/scholar?hl=en&q=general+anesthesia+memory&btnG=&as_sdt=1%2C5&as_sdtp=
      The data in rats is pretty strong. This is the first human study,

    • Re:Doubtful (Score:4, Informative)

      by buswolley ( 591500 ) on Monday June 09, 2014 @08:36PM (#47199265) Journal

      Note that the study included an experimental manipulation of anesthetic exposure in a sample of rats. This was an experimental manipulation which means that the author's could make a much stronger claim for causation. As far as mechanisms, this is being explored but it appears to be something that normal processes of synaptogenesis and synaptic pruning.

    • by Trogre ( 513942 )

      Would, then, damage caused by exposure to other chemicals such as ethanol not also be flushed in infants?

      I find that highly doubtful.

  • We've known for decades about the effect that alcohol (one particular CNS depressant) has on brain development. It seems reasonable to assume that other CNS depressants would have the same effect to some degree, at least up to the point where brain cell division stops (several months after birth, IIRC).

  • "causal relation as well as correlation". They are not mutually exclusive. On the contrary: the former requires the latter.
    • A correlational relationship is a specific one where correlation exists, but causality is missing/unproven. If there is both causality and correlation (and you're right about the former requiring the latter) then it's a causal relationship.
      Of course then there are also casual relationships, which are much better than the previous two types... :)
  • Selection bias (Score:4, Insightful)

    by Anonymous Coward on Monday June 09, 2014 @08:42PM (#47199291)

    This suffers from heavy selection bias. Children who require general anesthesia in infancy overwhelmingly suffer from congenital malformations which portend a higher rate of subclinical CNS developmental malfunction typically manifesting as mild developmental delay. (I'm a pediatric surgeon).

    • I wondered about that. General surgery in infants is anything but common. You don't do it unless you have to. Certainly there are some other wise normal children who need general anesthesia - say from trauma, but many of them have pre existing conditions that makes them not a good 'normal'. Not sure how the rats figure into this though. What's a normal rat? A politician? A lawyer?

    • Re: (Score:3, Insightful)

      by Anonymous Coward

      This is true. However, the complimentary data in rats, where pre-existing conditions were controlled, suggests that this is not the primary driver of these results in humans. Of course, there is a decently sized literature examining these effects in rats already; the dispute was whether it would be observed in humans. More research in humans is needed, of course, but I am sure you understand that experimental manipulation of anesthetic exposure in human infants is unethical. With more research money, I ima

    • by Anonymous Coward

      This suffers from heavy selection bias. Children who require general anesthesia in infancy overwhelmingly suffer from congenital malformations which portend a higher rate of subclinical CNS developmental malfunction typically manifesting as mild developmental delay. (I'm a pediatric surgeon).

      Circumcision (Male Genital Mutilation) used to be performed in the United States quite often without any anesthetic, but these days they may use local or general anesthesia if the parents insist on it. And since it is such a depressingly common procedure, I cant believe your comment that there would be heavy selection bias, since its done to many otherwise healthy baby boys.

    • by Hodr ( 219920 )

      Good point. But how did the researcher manage to find so many rats with similar birth defects to choose for his study?

    • That's why they did the control study with rats. Needs more to be certain it's causal sure, but that's a good indication it might be.
    • Maybe so, but I was born with neuroblastoma in my chest -- not a "birth defect" in the usual sense, and nothing to do with my brain. I had surgery to remove the tumor at 10 days old (based on the scar, safe to say general anasthesia was used), followed by radiation and chemo. I've also been plagued with a crappy short-term memory my whole life (like, going downstairs for a drink, getting there, and not remembering why I went to the kitchen). If anything I always thought maybe it was the radiation, which
  • Who would have guessed that a drug-induced coma, a chemical that literally knocks you the fuck out, would have any kind of long-term effect whatsoever on the brain? Is this seriously news? Did anyone seriously not just kind of figure that such strong drugs for the purpose of suspending the brain would have, you know, mental effects?

    • Guessing that anesthesia has long term effects on the brain certainly isn't news. But demonstrating it using a controlled experiment is news indeed.

  • I was operated on for a hernia at about 6 weeks of age. In 1954, I would be really surprised if general anesthesia was not administered.

    I have no memory problems, as a matter of fact, I am renowned for my ability to remember facts and details. I guess I'm not a rat.
    • Do you remember if you were given general anesthesia or not for your surgery when you were 6 weeks old?

  • Of course they used as a control a group of children who underwent the procedure without anesthesia?

    • You will understand that a controlled experimental manipulation of anesthetic exposure in humans is unethical. As a first step, this retrospective study had to be conducted, I am sure.

  • I distrust medicine much more than anybody I know. However, our pediatrician scared us into having my kid go through an MRI for a "possibly serious condition" when he was a few months old. Naturally nothing was wrong.

    Now he is seven years old... and by fucking golly his memory is scarily good in all situations. My memory is better than at least 99% of adults I meet. The kid puts me to shame. Not only can he easily best me at any memory type of game, his episodic memory is incredible. He'll remember I promis

If you have a procedure with 10 parameters, you probably missed some.

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