Devan Darby Bartels1, Mary Ellen McCann2, Andrew J Davidson3, David M Polaner4, Elizabeth L Whitlock5, Brian T Bateman6. 1. Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Anesthesia, Boston Children's Hospital, Boston, MA, USA. 3. Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, VIC, Australia. 4. Departments of Anesthesia and Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. 5. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA. 6. The Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
INTRODUCTION: Understanding the duration of pediatric general anesthesia exposure in contemporary practice is important for identifying groups at risk for long general anesthesia exposures and designing trials examining associations between general anesthesia exposure and neurodevelopmental outcomes. METHODS: We performed a retrospective cohort analysis to estimate pediatric general anesthesia exposure duration during 2010-2015 using the National Anesthesia Clinical Outcomes Registry. RESULTS: A total of 1 548 021 pediatric general anesthetics were included. Median general anesthesia duration was 57 minutes (IQR: 28-86) with 90th percentile 145 minutes. Children aged <1 year had the longest median exposure duration (79 minutes, IQR: 39-119) with 90th percentile 210 minutes, and 13.7% of this very young cohort was exposed for >3 hours. High ASA physical status and care at a university hospital were associated with longer exposure times. CONCLUSION: While the vast majority (94%) of children undergoing general anesthesia are exposed for <3 hours, certain groups may be at increased risk for longer exposures. These findings may help guide the design of future trials aimed at understanding neurodevelopmental impact of prolonged exposure in these high-risk groups.
INTRODUCTION: Understanding the duration of pediatric general anesthesia exposure in contemporary practice is important for identifying groups at risk for long general anesthesia exposures and designing trials examining associations between general anesthesia exposure and neurodevelopmental outcomes. METHODS: We performed a retrospective cohort analysis to estimate pediatric general anesthesia exposure duration during 2010-2015 using the National Anesthesia Clinical Outcomes Registry. RESULTS: A total of 1 548 021 pediatric general anesthetics were included. Median general anesthesia duration was 57 minutes (IQR: 28-86) with 90th percentile 145 minutes. Children aged <1 year had the longest median exposure duration (79 minutes, IQR: 39-119) with 90th percentile 210 minutes, and 13.7% of this very young cohort was exposed for >3 hours. High ASA physical status and care at a university hospital were associated with longer exposure times. CONCLUSION: While the vast majority (94%) of children undergoing general anesthesia are exposed for <3 hours, certain groups may be at increased risk for longer exposures. These findings may help guide the design of future trials aimed at understanding neurodevelopmental impact of prolonged exposure in these high-risk groups.
Authors: James D O'Leary; Magdalena Janus; Eric Duku; Duminda N Wijeysundera; Teresa To; Ping Li; Jason T Maynes; Mark W Crawford Journal: Anesthesiology Date: 2016-08 Impact factor: 7.892
Authors: Lena S Sun; Guohua Li; Tonya L K Miller; Cynthia Salorio; Mary W Byrne; David C Bellinger; Caleb Ing; Raymond Park; Jerilynn Radcliffe; Stephen R Hays; Charles J DiMaggio; Timothy J Cooper; Virginia Rauh; Lynne G Maxwell; Ahrim Youn; Francis X McGowan Journal: JAMA Date: 2016-06-07 Impact factor: 56.272
Authors: Randall P Flick; Slavica K Katusic; Robert C Colligan; Robert T Wilder; Robert G Voigt; Michael D Olson; Juraj Sprung; Amy L Weaver; Darrell R Schroeder; David O Warner Journal: Pediatrics Date: 2011-10-03 Impact factor: 7.124
Authors: Ansgar M Brambrink; Alex S Evers; Michael S Avidan; Nuri B Farber; Derek J Smith; Xuezhao Zhang; Gregory A Dissen; Catherine E Creeley; John W Olney Journal: Anesthesiology Date: 2010-04 Impact factor: 7.892
Authors: Cor J Kalkman; Linda Peelen; Karel G Moons; Morna Veenhuizen; Marcel Bruens; Gerben Sinnema; Tom P de Jong Journal: Anesthesiology Date: 2009-04 Impact factor: 7.892
Authors: M Ruth Graham; Marni Brownell; Daniel G Chateau; Roxana D Dragan; Charles Burchill; Randal R Fransoo Journal: Anesthesiology Date: 2016-10 Impact factor: 7.892
Authors: Ethan Y Brovman; Rodney A Gabriel; Robert W Lekowski; Richard P Dutton; Richard D Urman Journal: J Cardiothorac Vasc Anesth Date: 2015-08-10 Impact factor: 2.628
Authors: Mary Ellen McCann; Jurgen C de Graaff; Liam Dorris; Nicola Disma; Davinia Withington; Graham Bell; Anneke Grobler; Robyn Stargatt; Rodney W Hunt; Suzette J Sheppard; Jacki Marmor; Gaia Giribaldi; David C Bellinger; Penelope L Hartmann; Pollyanna Hardy; Geoff Frawley; Francesca Izzo; Britta S von Ungern Sternberg; Anne Lynn; Niall Wilton; Martin Mueller; David M Polaner; Anthony R Absalom; Peter Szmuk; Neil Morton; Charles Berde; Sulpicio Soriano; Andrew J Davidson Journal: Lancet Date: 2019-02-14 Impact factor: 79.321
Authors: Jeffrey T Young; Roza M Vlasova; Brittany R Howell; Rebecca C Knickmeyer; Elyse Morin; Kaela I Kuitchoua; Gabriele R Lubach; Jean Noel; Xiaoping Hu; Yundi Shi; Gibson Caudill; Andrew L Alexander; Marc Niethammer; Merle G Paule; Christopher L Coe; Mar Sanchez; Martin Styner Journal: Br J Anaesth Date: 2021-02-03 Impact factor: 11.719
Authors: Abdulmajeed Alajlan; Bader M Alhabeeb; Ali M Alhazmi; Osama A Alobaid; Ahmed A Alharthi; Nada I Al-Habib; Ahmed M El-Malky Journal: Dermatol Res Pract Date: 2020-05-30
Authors: Francesca M Manzella; Srdjan M Joksimovic; James E Orfila; Brier R Fine; Robert M Dietz; Dayalan Sampath; Hanna K Fiedler; Vesna Tesic; Navya Atluri; Yogendra H Raol; Vesna Jevtovic-Todorovic; Paco S Herson; Slobodan M Todorovic Journal: Front Syst Neurosci Date: 2020-05-26
Authors: Jenny X Chen; Elliott Kozin; Jordan Bohnen; Brian George; Daniel Deschler; Kevin Emerick; Stacey T Gray Journal: Laryngoscope Investig Otolaryngol Date: 2019-11-11