General Anesthetics Toxicity, Neurodevelopment, Infant
Conditions
Keywords
General anesthesia, Infant, Neurodevelopment, Postoperative, the Gesell Developmental Inventory
Brief summary
Numerous preclinical evidence has confirmed that most commonly-used general anesthetics can affect neurodevelopment of young animals adversely, causing both structural defect of brain and cognitive impairment. However, it is unclear at present whether such effect would also occur to children exposed to general anesthesia in their early life. Several observational clinical studies and one interventional clinical trial indicated that short-time general anesthesia less than 80 minutes might be safe to cognitive development. Concerning long-time and/or multiple anesthesia exposure, some studies supported its association with long-term cognitive defects, while other studies did not. These studies are mainly retrospective or ambirectional researches. We have designed a prospective, multicenter cohort study to examine the neurodevelopment of infants exposed to anesthesia before age 2 in the first year after surgery, and compare the neurodevelopment status of infants exposed to anesthesia less than 3 hours and those more than 3 hours. The Gesell Developmental Inventory (GDI) and several neuropsychological testing batteries will be used. The anticipated outcome of the study will add reliable evidence from Asians to elucidate the relationship of anesthesia and long-term neurodevelopment of infants.
Interventions
General anesthesia required for surgery procedures or diagnostic interventions using either intravenous or inhalation anesthetics, or both.
Sponsors
Shanghai Children's Medical Center
Children's Hospital of Fudan University
Shanghai Children's Hospital
Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Huashan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
4 Weeks to 2 Years
Healthy volunteers
No
Inclusion criteria
* Apgar score ≥ 8 at birth * ASA level Ⅰ\ Ⅲ * Obtained written consent form from the infants' parents or guardians
Exclusion criteria
* Postmenstrual age ≤ 44 weeks, or postmenstrual age ≥ 144 weeks * Severe cardiac, pulmonary, or neurologic disease * Severe obstructive sleep apnea hypopnea syndrome * History of dystocia and/or hypoxic ischemic encephalopathy * Gestational age at birth ≤32 weeks * Any known or suspected chromosomal abnormalities, abnormal development of vision or hearing, neurodevelopment retardation, or other known acquired or congenital abnormalities that might affect neurodevelopment * Significant cardiovascular surgery, significant ENT surgery, or neurosurgery * Malignant diseases that may reduce survival * Taking part in other clinical trials in the last 3 months or at present
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of the developmental quotient of the Gesell Developmental Inventory | From baseline before anesthesia to 1 year after anesthesia | The Gesell Developmental Inventory has been translated into Chinese and standardized by the Beijing Children's Health Care Institute and the performance results are expressed as a developmental quotient (DQ). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of the standardized score of the five domains of the Gesell Developmental Inventory | From baseline before anesthesia to 1 year after anesthesia | The five behavioral domains are gross motor, fine motor, language, adaptive, and personal-social behaviors. |
| Change of the standardized score of the Social Maturity Scale | From baseline before anesthesia to 1 year after anesthesia | The Social Maturity Scale includes six domains and 132 questions designed to be completed by the parents. |
Countries
China
Contacts
Primary ContactXiao-Yu Yang, M.D.
Backup ContactMeng-Qiang Luo, M.D.
Outcome results
None listed