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Anesthesia

Long term psychological effects of anesthesia

09/25/2006

Question:

I am a 16 year old female. I was born with congenital open angled glaucoma and also congenital cataracts. My cataracts were removed about 9 days after my brirth. Since then I have had over 30 surgeries and EUAs, most of them when I was younger. Even though I haven`t had one in over a few years, is it possible that all that excessive use of anesthesia could have some sort of long term psychological effects? Is it harmful to young children?

Answer:

I don't think anybody knows whether accumulated exposure to anesthetics can cause harm to the developing brain. This is one of the question you are asking. There are some recent studies in young rats showing prolonged damaging effects on the brain after several hours of anesthesia. This is a real source of concern to people in my profession but nobody knows whether these findings apply to humans. There are many examples of research findings in animals that do not at all apply to humans.

The problem with human research in this area is that anesthesia is hardly ever given by itself but is almost always given to facilitate surgery. The "stress response" to surgery has been suggested as a possible mechanism for prolonged effects on mental function that seem to occur in the elderly after surgery. Perhaps this is true in children also but we simply don't know. The flip side is that even newborns and very young babies do experience pain during medical and surgical procedures. Without anesthesia even minor procedures can be very stressful, and harmful, to these young patients.

As far as the psychological effects are concerned, there are of course likely to be effects on any child, in fact, any person, who has had as much surgery, and spent as much time in hospital as you have. Without being a psychologist myself I would say that how well, or badly, you deal with this much difficulty in your life will depend on some combination of your innate character, the support you have had from your family and friends, and on the quality of care you have had from your doctors and hospital. To say that you had an "excessive" amount of anesthesia is perhaps just an unfortunate choice of words. The anesthesia was necessary as you could not have had the benefit of restored or preserved sight (I hope) without it.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University