Anesthesia exposure before age 4 years was associated with an increased risk of learning disabilities (LD) in children, particularly with multiple anesthetics. A population-based study of 5,357 children born between 1976 and 1982 in Olmsted County, Minnesota, found that children who received two or more anesthetics before age 4 had a 59% increased risk of LD (hazard ratio = 1.59) and those with three or more anesthetics had a 120% increased risk (hazard ratio = 2.60). The risk increased with longer cumulative anesthesia exposure. However, single anesthetic exposure was not associated with increased LD risk. The study suggests that anesthesia exposure may be a risk factor for LD, but cannot determine whether anesthesia itself causes LD or if the need for anesthesia is a marker for other factors. The study highlights the importance of considering the potential neurotoxic effects of anesthesia on developing brains, especially in early life. The findings indicate that repeated anesthetic exposure may have adverse effects on neurodevelopment, but further research is needed to confirm the causal relationship. The study also notes that the results may not be generalizable to other populations due to the predominantly white, middle-class nature of the study population. Overall, the study underscores the need for further research to understand the long-term effects of anesthesia on children's neurodevelopment.Anesthesia exposure before age 4 years was associated with an increased risk of learning disabilities (LD) in children, particularly with multiple anesthetics. A population-based study of 5,357 children born between 1976 and 1982 in Olmsted County, Minnesota, found that children who received two or more anesthetics before age 4 had a 59% increased risk of LD (hazard ratio = 1.59) and those with three or more anesthetics had a 120% increased risk (hazard ratio = 2.60). The risk increased with longer cumulative anesthesia exposure. However, single anesthetic exposure was not associated with increased LD risk. The study suggests that anesthesia exposure may be a risk factor for LD, but cannot determine whether anesthesia itself causes LD or if the need for anesthesia is a marker for other factors. The study highlights the importance of considering the potential neurotoxic effects of anesthesia on developing brains, especially in early life. The findings indicate that repeated anesthetic exposure may have adverse effects on neurodevelopment, but further research is needed to confirm the causal relationship. The study also notes that the results may not be generalizable to other populations due to the predominantly white, middle-class nature of the study population. Overall, the study underscores the need for further research to understand the long-term effects of anesthesia on children's neurodevelopment.