A retrospective cohort study of the association of anesthesia and hernia repair surgery with behavioral and developmental disorders in young children.
A retrospective cohort study of the association of anesthesia and hernia repair surgery with behavioral and developmental disorders in young children.
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DOI：
10.1097/ana.0b013e3181a71f11
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发表时间：
2009-10
影响因子：
3.7
通讯作者：
Li G
中科院分区：
文献类型：
--
作者：
DiMaggio C;Sun LS;Kakavouli A;Byrne MW;Li G
最近的动物研究表明，常用的麻醉剂可能对发育中的大脑有严重的神经毒性作用。本研究的目的是评估疝修补手术与幼儿行为和发育障碍风险之间的相关性。我们对参加纽约州医疗补助计划的儿童进行了回顾性队列分析。我们的分析包括以下383名在出生后三年内接受腹股沟疝修补术的儿童的出生队列，以及5050名在3岁之前没有疝修补术史的儿童的样本。在控制了年龄、性别和出生相关并发症（如低出生体重）后，3岁以下接受疝修补术的儿童随后被诊断为发育或行为障碍的可能性是对照组儿童的两倍多（校正HR 2.3，95% CI 1.3，4.1）。我们的研究结果增加了最近的证据表明，手术及其同时暴露于麻醉剂与神经毒性的潜在关联，并强调需要对儿童手术和麻醉的长期影响进行更严格的临床研究。
Recent animal studies have shown that commonly used anesthetic agents may have serious neurotoxic effects on the developing brain. The purpose of this study was to assess the association between surgery for hernia repair and the risk of behavioral and developmental disorders in young children. We performed a retrospective cohort analysis of children who were enrollees of the New York State Medicaid program. Our analysis involved following a birth cohort of 383 children who underwent inguinal hernia repair during the first three years of life, and a sample of 5050 children frequency-matched on age with no history of hernia-repair before age 3. After controlling for age, gender, and complicating birth-related conditions such as low birth weight, children who underwent hernia repair under three years of age were more than twice as likely as children in the comparison group to be subsequently diagnosed with a developmental or behavioral disorder (adjusted HR 2.3, 95% CI 1.3, 4.1). Our findings add to recent evidence of the potential association of surgery and its concurrent exposure to anesthetic agents with neurotoxicity and underscore the need for more rigorous clinical research on the long-term effects of surgery and anesthesia in children.