Is general anesthesia safe for babies?

The article is professionally consulted by Specialist Doctor I Nguyen Duc Thong - Anesthesiologist - General Surgery Department - Vinmec Danang International General Hospital.

According to scientists, the use of anesthesia in surgery for children under 2 years old can affect their ability to learn later in life. Compared with normal children of the same age, the risk of decreased learning ability increased more than 2 times in children who had undergone many times of anesthesia, especially for language problems.

From a physiological point of view, the neonatal period is calculated from the time of birth to 1 month of age for full-term infants; or several months for preterm infants.
Children who need surgery in the neonatal period are often emergency surgery because of birth defects; If not operated in time, it will endanger the life of the child. Currently, thanks to the advancement of ultrasound, in developed countries, birth defects are detected early and can be treated from the fetal stage or with resuscitation and treatment from birth. .
General anesthesia for newborns is the biggest challenge for anesthesiologists. As with all ages, the assessment of ASA III, IV operative status in the neonatal emergency indicates a high risk of anesthesia. The experience of the anesthesiologist plays an important role in the frequency of complications. According to the KEENAN study, the frequency of cardiac arrest in children under 1 year of age was 1,970/00 for non-pediatric anesthesiologists and 0% for pediatric anesthesiologists.

General anesthesia seems to be a very simple thing, but it is actually an extremely difficult technique and requires the operator to have extensive knowledge, about brain physiology, breathing, circulation... In that, the anesthesia for children is even more complicated. Children are not miniature adults, the calculation of drug doses must be very accurate, depending on health status, physical condition, ability to respond to drugs... Especially, for children with cleft lip and cleft palate With oral and respiratory malformations, anesthesia is even more difficult.

Some studies have shown that children who have had multiple operations under the age of 2 years: 36.6% have impaired learning ability later in life. In children who received surgery once: 23.6% had learning disabilities, while in the group of children who did not undergo surgery, anesthesia before 2 years of age was 21.2%. In addition, anesthesia is also associated with hyperactive children and affects brain development and memory in children.

Complications that can happen to children when under anesthesia can fall into two cases. First, the child has reflux under anesthesia. Parents need to comply with the issue of fasting children before surgery: 8 hours for solid foods; 6 hours for liquid food such as porridge, formula milk; 4 hours for breast milk; 2 hours for filtered water. If there is food or water in the stomach of the child during anesthesia, it is easy to vomit, vomit can back up the back of the throat, spill into the lungs and cause lung damage such as atelectasis, aspiration pneumonia, bronchospasm. But children often cannot bear hunger, many mothers love their children, but do not fully realize the serious effects of feeding their children before anesthesia, so they still bring food for children. In children, the esophagus is not fully developed, when the child is under anesthesia, lying on the back, the esophageal valve is open, which can easily cause food to reflux. At that time, the child breathes in food, cannot breathe and can die.
The second case is that the child has respiratory failure during anesthesia. During endotracheal anesthesia, if the endotracheal tube is placed not in the airway but mistakenly placed in the oesophagus, or the tube is slipped... it can cause the child to quickly suffer from respiratory failure, leading to brain loss and death. . This is a very dangerous complication, it must be detected quickly and properly treated within less than 5 minutes to hopefully help the patient overcome the danger.
Moreover, for children, intervention to treat cleft lip and palate is a major surgery, with many potential risks, not a minor surgery as many people think. Children with this defect often have weak muscles and may have multiple malformations, especially congenital heart defects, so they cannot be operated everywhere. If the requirements for facilities, equipment, and doctors' skills are not met, it will be difficult when an accident such as spasm, heart failure, respiratory failure, anaphylaxis occurs... handled and corrected in a timely manner.

Therefore, in cases where it is necessary to do surgery for children, parents should take their children to large surgical centers so that specialized doctors can review their child's condition and offer effective treatment. best. At the same time, anesthesiologists can examine and advise on the risks of anesthesia for each child.
Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.
Doctor Duc Thong has 14 years of experience in the field of Anesthesia. Especially, with 12 years working at the Department of Anesthesiology and Resuscitation at C Da Nang Hospital, Dr. Thong has extensive experience in the field of Anesthesia and resuscitation for elderly patients with many comorbidities and serious illnesses. surgery; helping many heavy and complicated surgeries to be successful. Currently, he is an anesthesiologist at the Department of General Surgery - Vinmec Da Nang International General Hospital.