FDA warns that anesthesia can cause child brain damage
Six tips for lowering anesthesia risk in children
Are you deciding whether to get your child ear tubes, dental work, or other surgeries that may require general anesthesia or a sedation drug?
Are you pregnant and may need a surgery that requires you to be in drug-induced unconsciousness?
If so, then you should know about the U.S. Government’s recent anesthesia warnings.
FDA warns that anesthesia can harm infants and children
On December 14, 2016, the U.S. Food and Drug Administration (FDA) announced that it “is warning that repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children’s brains.”
On April 27, 2017, the FDA took further steps to protect infants and children by warning that “studies in young animals and pregnant animals that showed exposure to general anesthetic and sedation drugs for more than 3 hours can cause widespread loss of nerve cells in the developing brain; and studies in young animals suggested these changes resulted in long-term negative effects on the animals’ behavior or learning.”
FDA recommends delaying surgeries and procedures, if possible, for young children
Of all the new warnings, this is the one that most caught my attention. The new FDA rules require labels to include the warning that “surgeries or procedures in children younger than 3 years should not be delayed or avoided when medically necessary. Consideration should be given to delaying potentially elective surgery in young children where medically appropriate.”
I immediately thought of all the children who go through anesthesia to get ear tubes, even when they are younger than three years old.
Why is there an increased anesthesia risk in children?
Chemically speaking, general anesthesia and sedation are achieved through the medical use of neurotoxins. Neurotoxic effects can be more severe on developing brains than older adults.
A pediatric anesthesiologist at Texas Children’s Hospital co-authored an article in the New England Journal of Medicine urging caution about the new FDA labeling rules.
The Texas Children’s doctor believes that some studies show that there is no negative cognitive or neurologic damage when a young child had a single, brief exposure to anesthesia. There is a notable absence of studies, though, that support that conclusion for children who repeatedly receive anesthesia or are sedated for three hours or more.
Experts on both sides of this issue recommend that parents and doctors have a candid discussion weighing the risks and benefits of any procedure requiring anesthesia for a child.
Tips for safer pediatric anesthesia
Here are some things to discuss with ask your child’s doctor, surgeon, dentist, or anesthesiologist:
Can the procedure be delayed until the child is older? The age range of two to six years old is optimal for certain pediatric surgeries. When there is an age range available, parents may consider a later age within the range.
What are the available options for sedation and anesthesia, if it is absolutely necessary? Can the anesthesiologist use a local or regional anesthesia? In some rare circumstances, the anesthesiologist can use a spinal anesthesia for a lower body procedure.Are there other anesthesia options, such as light sedation plus a local anesthesia?
Are diagnostic tools available that do not require general anesthesia? For a child to sit still in an MRI scanner, he or she may need general anesthesia. Is there a different test that would be effective?
Are there preventative measures that could be tried before resorting to a surgery for ear tubes, for instance? Some experts have found that an over-the-counter decongestant can keep an ear infection at bay, if it is given at the first sign of congestion or a cold.
If your child’s dentist recommends general anesthesia, like propofol, ask about every other possible option, including sedation.
Finally, as an experienced Houston medical malpractice lawyer, I have handled a number of cases where there were terrible injuries and deaths from anesthesia complications. In each of those cases, the anesthesia was being run by a certified register nurse anesthetist (CRNA), rather than an anesthesiologist medical doctor.
Thus, if you have to consent to anesthesia for your child—or for yourself, for that matter—make sure that you discuss and fully understand exactly what anesthesia provider will be in the room during the surgery or procedure. I recommend that you ask for an anesthesiologist.
We are here to help
If you or someone you care for has been seriously injured as a result of anesthesia complications or errors, call 281-580-8800 for a free consultation with one of Painter Law Firm’s experienced medical negligence lawyers.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements [...]read more
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes [...]read more
A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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