Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial
Hypothesis: "The composite cognitive score of the Bayley III measured at 2 years of age in infants who are anaesthetized for inguinal herniorrhaphy will be equivalent when using GA compared with awake-regional anaesthesia."
Methods: International, multi-center trial comparing neurodevelopmental outcomes in 2 year-olds who underwent inguinal hernia repair randomized to GA or awake-regional anesthesia as infants.
Results: Scores on the cognitive tests were equivalent between the two groups.
Strengths: RCT, multi-center, international, generalizable, imputed effect estimates using best and worst case scenarios yielded similar results
Weaknesses: Describes a secondary outcome (study powered to evaluate outcomes at 5 years of age), 14% of patients lost to follow-up, significant number of patients failed awake-regional anesthesia
Key Point: A limited exposure to general anesthesia in infants undergoing hernia repair does not result in negative neurocognitive outcomes at 2 years of age.