Pediatric anesthesia & critical care
Association of sedation and anesthesia on cognitive outcomes in very premature infants: a retrospective observational study
Authors' conclusion
Exposure of very preterm infants to anesthetics/sedatives on the United States Food and Drug Administration warning list was associated with a decrease in FSIQ points at 36 months CA.
Study context
- Population
- Very preterm infants born at < 29 weeks of gestation, 2006–2012, with cognitive outcomes assessed at 36 months corrected age (CA)
- Participants
- 731 infants
- Exposure
- Exposure vs no exposure to FDA-warned anesthetics/sedatives
- Outcome
- Full-scale intelligence quotient (FSIQ; standardized mean (SD) 100 (15))
- Follow-up
- 36 months corrected age
Methodological detailsimputed and complete case analyses, multivariable linear regression
- Imputed and complete case analyses
- Multivariable linear regression
Main finding
As reported in the abstract
FSIQ points, warned medications (adjusted) · 36 months CA
Adjusted association
−3 FSIQ points
95% CI −7 to 0P = 0.045
imputed analysis
Adjusted association
−4 FSIQ points
95% CI −8 to 0P = 0.071
complete case analysis
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| FSIQ points, warned medications (unadjusted) · 36 months CAWarned medications vs No exposure · imputed analysis | unadjusted association −7 FSIQ points (95% CI −10 to −4) | P < 0.001 |
| FSIQ points, warned medications (unadjusted) · 36 months CAWarned medications vs No exposure · complete case analysis | unadjusted association −6 FSIQ points (95% CI −10 to −3) | P < 0.001 |
| FSIQ points, volatile anesthetic exposure only (adjusted) · 36 months CAVolatile anesthetic only vs No exposure · imputed analysis | adjusted association −3 FSIQ points (95% CI −6 to 0) | P = 0.072 |
| FSIQ points, volatile anesthetic exposure only (adjusted) · 36 months CAVolatile anesthetic only vs No exposure · complete case analysis | adjusted association −5 FSIQ points (95% CI −9 to −2) | P = 0.004 |
Full-scale intelligence quotient (FSIQ) and opioid exposure
- FSIQ was not associated with opioid exposure
Original publication
Association of sedation and anesthesia on cognitive outcomes in very premature infants: a retrospective observational study. Can J Anaesth. Published 19 December 2022. doi:10.
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