Anesthesia and Sedation Exposure and Neurodevelopmental Outcomes in Infants Undergoing Congenital Cardiac Surgery: A Retrospective Cohort Study

( Anesthesiology . 2023;139(4):393–404. doi: 10.1097/ALN.0000000000004684) Neurodevelopmental disability is common among those who undergo congenital cardiac surgery, with significant cognitive and motor delays often observed in long-term studies. Children undergoing cardiac surgery are at greater risk due to longer procedures and often many anesthetic exposures. This retrospective cohort study was a secondary analysis of a prospective observational study that investigated the impact of volatile anesthetics and sedatives on infants with congenital heart disease who had surgery at the Children’s Hospital of Philadelphia in Pennsylvania. The study sought to assess the association between neurodevelopmental outcomes and cumulative exposure to sedatives and anesthetics during the first 18 months of life, hypothesizing that greater exposure would lead to lower neurodevelopmental scores. Secondarily, the analysis also examined patterns of sedation and how anesthesia was administered in these infants.