Is anesthesia for children safe?
Anesthesia for children is safe in experienced hands and well-organized departments. However, problems can occur more often in younger patients which can cause harm and even death. A recent study showed that 1 in 20 children undergoing anesthesia have at least one problem. In some countries there is a much higher rate of problems.
Why may children get more problems with anesthesia?
Smaller, younger and sicker children may have more problems with anesthesia because there is a smaller safety margin around normal and changes from normal can happen much more quickly. This is especially so in emergency or urgent cases. The team needs a lot of training and experience to look after children to keep them safe during and after anesthesia and surgery.
Does my child need a general anesthetic?
No child should ever undergo a procedure or test that is not needed. If a procedure or test is needed in a child, especially if it may cause distress or pain, or if it may take a long time, or needs the child to be very still, then anesthesia may be needed. Sometimes sedation is an alternative but often anesthesia is more reliable and as safe or safer. If no anesthesia was given for such tests or procedures the results would be bad and severe distress and harm could be caused.
Is there one anesthetic that is better than others?
At the moment there is no proof that one way of giving anesthesia is better than any other.
Is repeated exposure or long anesthesia more harmful?
A single short anesthetic is safe and does not affect long-term brain development. Children who need lots of procedures or who require long anesthesia usually have other problems that can affect development.
Do anesthetic agents affect the intelligence and development of my child?
There is no evidence in humans that this is the case. There is a possibility that some delays occur in very specific areas and under very specific circumstances but this has to be balanced against the need for the procedure.
Is there a specific age when anesthetic agents will affect my child more?
There is currently no evidence to suggest a specific ‘safe’ age. Younger children have an increased risk of problems (see above). The best age for a procedure should be discussed openly with your team as for some there are risks in delaying or postponing procedures.
Is it ok to ask if my surgeon and anesthesiologist are qualified to look after my child?
Absolutely: Evidence of qualifications, training, and experience should be available and your doctor will be able to show this at an appropriate time. Many doctors also take part in quality assurance programs. Some hospitals have a special accreditation for care of children and are subject to peer review to make sure standards are met and maintained.
- Weiss M, Hansen TG, Engelhardt T. Ensuring safe anaesthesia for neonates, infants and young children: what really matters.
Arch Dis Child. 2016; 101: 650-2.
- Becke K, Höhne C, Eich C, Engelhardt T, Hansen T, Weiss M. Kinderanästhesie: Was wirklich wichtig ist [Paediatric Anaesthesia: What really matters]. Dtsch Arztebl 2017; 114(4): A-166 / B-148 / C-148
- Hansen TG. Use of anaesthetics in young children: Consensus statement of the European Society of Anaesthesiology, the European Society for Paediatric Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology and the European Safe Tots Anaesthesia Research Initiative. Eur J Anaesthesiol. 2017; 34: 327-8.
- Davidson A, Vutskits L. The new FDA drug safety communication on the use of general anesthetics in young children: what should we make of it? Paediatr Anaesth. 2017; 27: 336-7.
Joint Professional Guidance on the use of general anaesthesia in young children. Association of Paediatric Anaesthetists Great Britain and Ireland (APAGBI), Royal College of Anaesthetists, Association of Anaesthetists Great Britain and Ireland (AAGBI) and The College of Anaesthetists of Ireland. (https://www.rcoa.ac.uk/news-and-bulletin/rcoa-news-and-statements/joint-professional-guidance-the-use-of-general)
Use of anesthetics in young children Consensus statement of the European Society of Anaesthesiology (ESA), the European Society for Paediatric Anaesthesiology (ESPA), the European Association of Cardiothoracic Anaesthesiology (EACTA), and the European Safe Tots Anaesthesia Research Initiative (EuroSTAR) (http://onlinelibrary.wiley.com/doi/10.1111/pan.13160/abstract)