Even healthy children sometimes need surgery or other procedures that would not be possible without the use of sedatives and anesthesia medications that induce sleep and block pain. Medications for sedation and anesthesia are given to millions of children every year to ensure their health, safety, and comfort during surgery and other procedures for diagnosis or treatment.
Some research suggests that repeated or prolonged use of general anesthetics or sedative medications in young animals and children may affect the developing brain. These effects are subtle, and may include learning, memory, or behavior problems.
The U.S. Food and Drug Administration (FDA) has issued a warning that children under 3 years of age who receive anesthesia for more than 3 hours, or who need anesthesia on multiple occasions, are more likely to be affected.
Fortunately, recent studies indicate that a single brief exposure to general anesthesia or sedation is unlikely to affect behavior or learning, even in children less than 3 years old. No specific anesthetic or sedative medication has been shown to be safer than any other. A 2018 study published in the Journal of the American Medical Association, Pediatrics looked at sibling pairs. Children who had surgical procedures that require general anesthesia before primary school entry were not found to be at increased risk of problems with development compared with their biological siblings who did not have surgery or anesthesia.
Anesthetic and sedative medications are necessary for infants and children who require surgery or other painful or stressful procedures. The experience of pain, if it is not treated, may be harmful to children and their developing nervous systems.
If surgery or any procedure is recommended for your child, ask for information including how long the procedure will take, and the possible need for any repeated procedures.
Parents should consider the possible effects of anesthesia on brain development, and consider whether surgery could safely be delayed until the child is older. The decision should be discussed with the child’s pediatrician, surgeon, anesthesiologist, and any other physician involved in the recommendation to have the procedure.
Life-threatening problems with the heart, lungs, or digestive system, for example, may require immediate surgery and should never be delayed.
But there are other common reasons why children sometimes need surgery. Though the problem -- such as crossed eyes, or chronic ear infections -- may not seem serious, it may be important not to delay surgery.
Other helpful resources:
- The SmartTots Collaborative, an organization working to make anesthesia safer for infants and children
- UCLA Mattel Children’s Hospital, Pediatric Anesthesiology
- US Food and Drug Administration
- Consensus Statement on Anesthesia and Brain Development