2026 Undergraduate Research Showcase

Long-Term Neurodevelopmental and Behavioral Outcomes Following Anesthesia in Pediatric Population

Document Type

Student Presentation

Presentation Date

4-24-2026

Faculty Sponsor

Dr. Ryoko Kausler

Abstract

Pediatric surgical procedures are common in the United States, with millions of anesthetics administered each year to children during critical periods of brain development. Emerging evidence, along with a 2016 FDA drug safety communication, has raised concerns that repeated or prolonged exposure to general anesthesia before age three may affect neurodevelopment, including long-term emotional and behavioral outcomes. This evidence-based practice project examines whether repeated or prolonged early childhood exposure to general anesthesia is associated with the development of anxiety and other behavioral outcomes later in childhood or adolescence. A structured PICOT question guided a literature search of CINAHL and MEDLINE (2015–2025), which resulted in ten peer-reviewed original research studies that were appraised for level and quality of evidence.

Overall, the findings suggest that single, brief exposures to general anesthesia are not associated with significant long-term neurodevelopmental deficits. However, repeated or prolonged exposures show a more consistent association with subtle behavioral changes, including increased risk of attention difficulties, learning disabilities, and anxiety-related symptoms. It is also important to recognize that many children who require multiple or prolonged exposures often have underlying health conditions and experience repeated hospitalizations, which may also influence these outcomes. Because of this, it can be difficult to determine whether the effects are directly related to anesthesia exposure or influenced by other factors.

Based on these findings, it is recommended that healthcare providers minimize repeated or prolonged anesthesia exposure when clinically appropriate, implement routine developmental and behavioral screenings for at-risk pediatric patients, and improve long-term follow-up through better documentation and interdisciplinary communication.

In conclusion, general anesthesia remains a necessary and generally safe part of pediatric care; however, repeated or prolonged exposure during early childhood may be associated with subtle long-term behavioral outcomes. Increasing awareness, early monitoring, and continued research are important to better understand these risks and support long-term outcomes in pediatric populations.

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