PMID- 35613046 OWN - NLM STAT- MEDLINE DCOM- 20230913 LR - 20230913 IS - 1537-1921 (Electronic) IS - 0898-4921 (Linking) VI - 35 IP - 4 DP - 2023 Oct 1 TI - Early Neurodevelopmental Outcomes Following Exposure to General Anesthesia in Infancy: EGAIN, a Prospective Cohort Study. PG - 394-405 LID - 10.1097/ANA.0000000000000857 [doi] AB - BACKGROUND: General anesthesia (GA) is known to worsen neural outcomes in animals, but human research assessing early-life GA exposure and neurodevelopment show inconsistent findings. We investigated the effects of a single GA exposure for minor surgery on the neurodevelopment of healthy children at multiple time-points, using clinical assessments along with behavioral and neurophysiological measures rarely used in human research. METHODS: GA-exposed children were a prospective cohort of 250 full-term, healthy infants who underwent GA for minor surgery before 15 months. Nonexposed children were from a separate cohort of similar age, sex, ethnicity, and maternal education. In both cohorts, clinical measures (Bayley Scales of Infant and Toddler Development-III [BSID-III] and Child Behavior Checklist [CBCL1(1/2)-5]) were assessed at 24 months, and experimental tests (memory and attentional) and neurophysiology (event-related potentials) at 6 and 18 months. RESULTS: At 24 months, there were no differences between GA-exposed and nonexposed children in the cognitive, language, motor, and socioemotional domains of the BSDI-III; however, GA-exposed children had poorer parental-reported scores in BSID-III general adaptability (94.2 vs. 99.0 [mean difference, 4.77; 97.3% confidence interval, -9.29, -0.24]; P =0.020) and poorer internalizing behavior scores on CBCL1(1/2)-5 (52.8 vs. 49.4 [mean difference, 3.35; 97.3% confidence interval, 0.15-6.55]; P =0.021). For experimental measures, GA-exposed children showed differences in 4 tests at 6 and 18 months. CONCLUSIONS: GA-exposed children did not differ from unexposed children in cognitive, language or motor outcomes at 24 months, but exhibited poorer parent-reported behavior scores. Differences in infant behavior and neurophysiology were detected at 6 and 18 months. Neurophysiological assessments may complement clinically relevant assessments to provide greater insights into neurodevelopment following early GA exposure. CI - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved. FAU - Bong, Choon Looi AU - Bong CL AD - Department of Pediatric Anesthesia, KK Women's and Children's Hospital. FAU - Ho, Duncun AU - Ho D AD - Duke-NUS Medical School. FAU - Allen, John Carson AU - Allen JC AD - Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Medical School. FAU - Lim, Gillian Si-Min AU - Lim GS AD - Nanyang Technological University. FAU - Tan, Hong-Kuang AU - Tan HK AD - Duke-NUS Medical School. FAU - Broekman, Birit F P AU - Broekman BFP AD - Neurodevelopment Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research. AD - Department of Psychiatry, Amsterdam UMC and OLVG, VU University Amsterdam, The Netherlands. FAU - Fabila, Teddy AU - Fabila T AD - Department of Pediatric Anesthesia, KK Women's and Children's Hospital. FAU - Reddy, Satish AU - Reddy S AD - Department of Pediatric Anesthesia, KK Women's and Children's Hospital. FAU - Koh, Woon-Puay AU - Koh WP AD - Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore. FAU - Swee-Kim Tan, Josephine AU - Swee-Kim Tan J AD - Department of Pediatric Anesthesia, KK Women's and Children's Hospital. FAU - Meaney, Michael AU - Meaney M AD - Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). AD - Department of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, QC, Canada. FAU - Rifkin-Graboi, Anne AU - Rifkin-Graboi A AD - Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). AD - Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore. LA - eng PT - Journal Article DEP - 20220526 PL - United States TA - J Neurosurg Anesthesiol JT - Journal of neurosurgical anesthesiology JID - 8910749 SB - IM MH - Humans MH - Infant MH - *Child Development MH - Prospective Studies COIS- The authors have no conflicts of interest to disclose. EDAT- 2022/05/26 06:00 MHDA- 2023/09/13 06:41 CRDT- 2022/05/25 13:22 PHST- 2022/01/06 00:00 [received] PHST- 2022/04/14 00:00 [accepted] PHST- 2023/09/13 06:41 [medline] PHST- 2022/05/26 06:00 [pubmed] PHST- 2022/05/25 13:22 [entrez] AID - 00008506-990000000-00016 [pii] AID - 10.1097/ANA.0000000000000857 [doi] PST - ppublish SO - J Neurosurg Anesthesiol. 2023 Oct 1;35(4):394-405. doi: 10.1097/ANA.0000000000000857. Epub 2022 May 26.