PANDA Symposium ProceedingsPediatric Anesthesia and Neurodevelopmental Impairments A Bayesian Meta-analysisDiMaggio, Charles PhD; Sun, Lena S. MD; Ing, Caleb MD; Li, Guohua MD, DrPHAuthor Information Department of Anesthesiology, Columbia University, New York, NY Supported by Grant 1R21CE001816-01 from the Centers for Disease Control and Prevention. The authors have no conflicts of interest to disclose. Reprints: Charles DiMaggio, PhD, Department of Anesthesiology, Columbia University, 622 West 168th St., New York, NY 10032 (e-mail: [email protected]). Received July 16, 2012 Accepted July 16, 2012 Journal of Neurosurgical Anesthesiology: October 2012 - Volume 24 - Issue 4 - p 376-381 doi: 10.1097/ANA.0b013e31826a038d Buy Metrics Abstract Experimental evidence of anesthesia-induced neurotoxicity has caused serious concern about the long-term effect of commonly used volatile anesthetic agents on young children. Several observational studies based on existing data have been conducted to address this concern with inconsistent results. We conducted a meta-analysis to synthesize the epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children. Using Bayesian meta-analytic approaches, we estimated the synthesized odds ratios (OR) and 95% credible interval (CrI) as well as the predictive distribution of a future study given the synthesized evidence. Data on 7 unadjusted and 6 adjusted measures of association were abstracted from 7 studies. The synthesized OR based on the 7 unadjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.9 (95% CrI, 1.2-3.0). The most likely unadjusted OR from a future study was estimated to be 2.2 (95% CrI, 0.6-6.1). The synthesized OR based on the 6 adjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.4 (95% CrI, 0.9-2.2). The most likely adjusted OR from a future study was estimated to be 1.5 (95% CrI, 0.5-4.0). We conclude that existent epidemiologic evidence suggests a modestly elevated risk of adverse behavioral or developmental outcomes in children who were exposed to anesthesia/surgery during early childhood. The evidence, however, is considerably uncertain. © 2012 Lippincott Williams & Wilkins, Inc.