ArticleAnesthesia and analgesia2021
Association Between Behavioral and Learning Outcomes and Single Exposures to Procedures Requiring General Anesthesia Before Age 3: Secondary Analysis of Data From Olmsted County, MN.
Article in Anesthesia and analgesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Early childhood exposure to general anesthesia and subsequent risk of learning disabilities: a systematic review and meta-analysis of cohort studies.BMC anesthesiology · 2026Pooled it
- Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- General anesthesia in children and long-term neurodevelopmental deficits: A systematic review.Frontiers in molecular neuroscience · 2022Pooled it
- Anesthetic-Induced Developmental Neurotoxicity: Cognitive Sequelae of Early Exposure.Anesthesia and critical care (Houston, Tex.) · 2026Article
- Somatostatin and its receptors involvement in sevoflurane-induced neurotoxicity: a narrative review.BMC anesthesiology · 2025Review
- Long-term neurodevelopmental outcomes should be addressed in robot-assisted abdominal surgery in small infants.International journal of surgery (London, England) · 2025Article
- The Relationship between Early Exposure to General Anesthesia and Neurobehavioral Deficits.Developmental neuroscience · 2025Review
- Effect of remimazolam toluene sulfonate on the cognitive function of juveniles and its mechanism of action.European journal of medical research · 2024Article
- Risk of attention deficit hyperactivity disorder diagnosis following multiple exposures to general anesthesia in the paediatric population: A systematic review and meta-analysis.Paediatrics & child health · 2024Article
- Experiencing anesthesia and surgery early in life impairs cognitive and behavioral development.Frontiers in neuroscience · 2024Article
- Inhibitory neuron map of sevoflurane induced neurotoxicity model in young primates.Frontiers in cellular neuroscience · 2023Article
- Anesthesia and developing brain: What have we learned from recent studies.Frontiers in molecular neuroscience · 2022Review
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8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundTwo prior population-based (children born in Olmsted County, MN), retrospective cohort studies both found that multiple exposures to anesthesia before age 3 were associated with a significant increase in the frequency of attention-deficit hyperactivity disorder (ADHD) and learning disabilities (LD) later in life. The primary purpose of this secondary analysis of these data was to test the hypothesis that a single exposure to anesthesia before age 3 was associated with an increased risk of ADHD. We also examined the association of single exposures with LD and the need for individualized educational plans as secondary outcomes.
methodsThis analysis includes 5339 children who were unexposed to general anesthesia before age 3 (4876 born from 1976 to 1982 and 463 born from 1996 to 2000), and 1054 children who had a single exposure to anesthesia before age 3 (481 born from 1976 to 1982 and 573 born from 1996 to 2000). The primary outcome of interest was ADHD. Secondary outcomes included LD (reading, mathematics, and written language) and the need for individualized educational programs (speech/language and emotion/behavior). To compare the incidence of each outcome between those who were unexposed and singly exposed to anesthesia before the age of 3 years, an inverse probability of treatment weighted proportional hazards model was used.
resultsFor children not exposed to anesthesia, the estimated cumulative frequency (95% confidence interval [CI]) of ADHD at age 18 was 7.3% (95% CI, 6.5-8.1) and 13.0% (95% CI, 10.1-16.8) for the 1976-1982 and 1996-2000 cohorts, respectively. For children exposed to a single anesthetic before age 3, the cumulative frequency of ADHD was 8.1% (95% CI, 5.3-12.4) and 17.6% (95% CI, 14.0-21.9) for the 1976-1982 and 1996-2000 cohorts, respectively. In weighted analyses, single exposures were not significantly associated with an increased frequency of ADHD (hazard ratio [HR], 1.21; 95% CI, 0.91-1.60; P = .184). Single exposures were also not associated with an increased frequency of any LD (HR, 0.98; 95% CI, 0.78-1.23), or the need for individualized education plans.
conclusionsThis analysis did not find evidence that single exposures to procedures requiring general anesthesia, before age 3, are associated with an increased risk of developing ADHD, LD, or the need for individualized educational plans in later life.
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