Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
J Neurosurg Anesthesiol. 2009 Oct;21(4):286-91. doi: 10.1097/ANA.0b013e3181a71f11.
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 3 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, sex, and complicating birth-related conditions such as low birth weight, children who underwent hernia repair under 3 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 hazard ratio 2.3, 95% confidence interval 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.
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。本研究旨在评估小儿疝修补术与行为和发育障碍风险之间的关联。我们对纽约州医疗补助计划的参保儿童进行了回顾性队列分析。我们的分析包括对在生命的头 3 年接受腹股沟疝修补术的 383 名儿童的出生队列进行随访，并对年龄匹配的 5050 名儿童进行了样本分析，这些儿童在 3 岁之前没有疝修补术史。在控制年龄、性别和出生相关并发症（如低出生体重）后，在 3 岁以下接受疝修补术的儿童与对照组儿童相比，随后被诊断为发育或行为障碍的可能性是对照组的两倍多（调整后的危险比 2.3，95%置信区间 1.3，4.1）。我们的研究结果增加了最近的证据，证明手术及其同时接触麻醉剂与神经毒性之间存在潜在关联，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。
