How anaesthesia impacts student learning outcomes

How anaesthesia impacts student learning outcomes

Exposure to general anaesthetic up to age of four raises the risk of poor child development and reduced literacy and numeracy as measured by school tests, a new study reveals.

University of Sydney researchers Professor Natasha Nassar and Dr Justin Skowno analysed school entry assessment scores and Year 3 NAPLAN results of more than 210,000 students in NSW between 2009-2014.

They found that children who were exposed to general anaesthesia had a 17% increased risk of poor development, a 34% increased risk of lower numeracy scores and a 23% increased risk of lower reading scores.

When the researchers restricted their analyses to children who’d had only one hospitalisation involving a procedure requiring general anaesthesia, they found no increased risk for poor development or reduced reading scores, however the risk of poor numeracy scores remained.

“There are many reasons why a child requires surgery or investigation, and, in some cases, this may be lifesaving or unavoidable,” said the study’s senior author, Professor Nassar said.

“For these children, our findings suggest that it is important to follow-up and monitor their literacy and numeracy skills when they reach school, and ensure early intervention, if required.”

However, the study’s co-author, Dr Skowno, said determining exactly what is causing this effect is not easy.

“The children receiving a general anaesthetic in this study also had surgery, and often had other associated medical conditions,” Dr Skowno said.

“There are some procedures where alternative approaches or management may be possible, but the majority of surgeries in young infants and children cannot easily be postponed.”

Dr Skowno said parents can discuss with their doctor and explore whether these procedures can be avoided, combined with other procedures, delayed to older ages or treated with alternatives to surgery, or other methods of sedation.

The researchers say further investigation of the specific effects of general anaesthesia on numeracy skills, underlying health conditions that prompt the need for surgery or diagnostic procedures is required, particularly among children exposed to previous or long duration of general anaesthesia or with repeated hospitalisations.