How dangerous is general anesthesia in children | Anaesthesia for children

How dangerous is general anesthesia in children

The decision to perform a medical procedure requiring general anesthesia is never made lightly, especially in children. Despite modern technology and extensive medical experience, surgery and the required general anesthesia always involve risks. Risky operations are not performed on children if surgery is possible at a later date.

The individual risk with general anesthesia always depends on the existing concomitant diseases, the general state of health and the duration of the anesthesia. The risk of dying from serious complications during general anesthesia or of permanent damage increases significantly with the so-called ASA score. This value is calculated from the existing concomitant diseases a person has.

In the case of existing relevant concomitant diseases, the value and the risk of anaesthesia increases significantly. Overall, general anesthesia can nevertheless be classified as low-risk. Some surgical interventions are only made possible by means of anaesthesia, and dangerous complications can be detected and eliminated by closely monitoring the child while unconscious.

Compared to operations on older people, children tolerate the anesthesia and the stress they are exposed to during the operation very well. Severe concomitant diseases are less common in children, and their general condition is generally very good. However, complications are more frequent in infants due to their still weak immune system, which is why some operations have to be postponed to a later date.

Current situation

Due to experimental experiments, mainly in animal models, voices have recently become louder suggesting possible brain cell damage in children caused by anesthesia. Due to the neurotoxicity of the anaesthetics, the learning ability of children is supposed to be limited by the anaesthetic received. After this correlation was discovered in animal models, several studies were started to investigate children who received an anesthetic early in life.

Studies were conducted in the USA and in Europe.The results of these studies, which were completed and published only some time ago, were quite different: Studies from Denmark and the Netherlands could not find any connection between a received narcosis and changes in the brain or behavior of the children. Only one study from the USA, which retrospectively examined children who received anesthesia more than once before the age of 4 years, could actually establish a connection between learning difficulties and the anesthesia received. Even after evaluation of all studies, a clear result is still unclear.

It is not considered certain whether the learning disorder that occurred in the children was actually caused by the anesthesia or rather by the operation(s) and the respective disease itself. In general, however, there is no alternative to general anesthesia for many operations. Only in rare cases can it be recommended to postpone an operation to a later date in order to avoid surgery during the developmental phase of the brain. Most operations on children are important procedures and must be performed at the appropriate time.