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Is Anesthesia Safe for Toddlers?

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Updated June 05, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Child Recovering in the Hospital
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Question: Is Anesthesia Safe for Toddlers?
The doctor says my 15-month-old needs to have an operation. I am very scared about giving her anesthesia. Is it safe for a child so young?
Answer: Surgery is a scary thing for both children and parents. We certainly want our children to be healthy, but "going under the knife" brings its own set of pains and discomforts. In the case of toddlers, the most common surgical procedures are usually used as a last resort. Common procedures include:
  • Tonsillectomy, in which the tonsils are removed, or a T&A (tonsillectomy and adenoidectomy), during which enlarged tonsils and adenoids are removed. These procedures are usually done to correct sleep apnea in young children who snore, and who are at risk for other health problems related to the condition.
  • Ear tube insertion, in which tubes are placed through the eardrums (the thin layer of tissue that separates the outer and middle ear). These tubes allow fluid behind the eardrums to drain. The procedure is done on children who have chronic ear infections as a way to reduce the rate of infection, and to enable their ears to function normally. In addition, tubes are typically used when chronic or recurrent middle ear infections impair hearing enough to potentially impact speech and language development.

Of course, there are thousands of other reasons that doctors might recommend a toddler for surgery—from congenital heart problems to correcting an orthopedic problem. In almost every case, a toddler will need to be given general anesthesia, which puts the child in a deep, comfortable sleep so he will not feel any pain during the procedure.

Weighing the Risks of Anesthesia

There are risks associated with anesthesia for every person—young and old—so it's understandable that you may be wary of putting your child under.

Recent studies have also raised concerns that children under 3 years of age who are exposed to anesthesia may have an increased risk of developing learning disabilities. A 2011 study and a 2012 study both show a possible link between significant language problems and cognitive impairment among children who underwent surgical procedures that included the use of general anesthesia.

The results of these studies might be reason to ask whether or not your child's surgery can be delayed a year or two until her brain is more fully developed. However, they should not cause you to delay necessary surgery. There are many questions that still exist about the link between surgery and possible learning disabilities. For instance, all of the children in the research that has been published to date were likely given halothane, a drug that is now no longer used in the United States. There are also still questions about whether other factors increase the risk of learning disabilities for children who undergo surgery or are given general anesthesia.

What You Can Do You may need to think of surgery as something akin to letting your child play on the jungle bars at the playground. There's a big chance that she'll fall, but the fact that your child builds physical strength, balance, and confidence is a huge reward for taking that risk.

With surgery, the risks may be greater, but in the case of healing a sick child, the rewards are also significantly greater. Any qualified doctor would never recommend unnecessary surgery on a small child. As a parent, then, it's your role to establish as many safety nets as possible.

Things you can do to protect your child :

  • Get a second opinion: Check with your insurance company to find another expert in the field to weigh in. If you end up with two differing suggestions, get a third opinion.
  • Ask about the anesthesiologist: You probably won't know specifically which anesthesiologist will be in the OR until the day of surgery, but you can research the anesthesiologist group that works with your hospital. While the American Board of Anesthesiology does not offer a pediatric anesthesia certification, practitioners can receive an acknowledgement of their qualification in pediatric anesthesia by completing an accredited fellowship in Pediatric Anesthesia. It's within your rights to request an anesthesiologist with this qualification.
  • Discuss the option of delaying surgery. This may mean waiting a few months to see if a problem resolves on its own. For instance, if a doctor recommends your child have ear tubes inserted in April, you might want to discuss waiting a few months since the seasonal change often brings fewer infections, and your child may be able to outgrow the problem before she even has another infection. You may also ask about non-surgical options, such as drug therapy, that offer safe ways to treat a child until he reaches his third birthday, when some of the risks of anesthesia might be lower.
Sources:

Ing, Caleb, M.D., et al. Long-term Differences in Language and Cognitive Function After Childhood Exposure to Anesthesia. Pediatrics. August 20, 2012.

Flick, Randall P., M.D., M.P.H., et al. Cognitive and Behavioral Outcomes After Early Exposure to Anesthesia and Surgery. Pediatrics. October 3, 2011.

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