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Postoperative behavioral changes following anesthesia with sevoflurane

Aideen Keaney1, Dara Diviney, Sinead Harte

  • 1Department of Anaesthesia & Critical Care Medicine, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.

Paediatric Anaesthesia
|September 24, 2004
PubMed

Insights

Sevoflurane anesthesia caused more immediate distress in children than halothane, but this did not lead to prolonged negative behavioral changes (NBC). Younger children were more prone to NBC after surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Child Psychology
  • Surgical Outcomes

Background:

  • Hospitalization can cause negative behavioral changes (NBC) in children, persisting for up to a month post-operation.
  • Sevoflurane anesthesia is associated with emergence excitement and postoperative delirium.
  • The study investigated if sevoflurane's immediate effects translate to prolonged behavioral changes.

Purpose of the Study:

  • To evaluate the impact of sevoflurane versus halothane anesthesia on prolonged postoperative behavioral changes in children.
  • To determine if immediate anesthetic-induced distress correlates with long-term behavioral disturbances.

Main Methods:

  • 120 children undergoing daycase surgery were randomized to sevoflurane or halothane anesthesia.
  • No additional sedatives were used.
  • Post-Hospital Behavior Questionnaire (PHBQ) assessed behavior on postoperative days 1, 7, and 30.

Main Results:

  • Children receiving sevoflurane showed greater distress upon emergence compared to halothane (P < 0.05).
  • NBC prevalence decreased over time: 58.3% (day 1), 46.8% (day 7), 38.3% (day 30).
  • No association found between anesthetic agent and long-term behavior; younger age correlated with higher NBC rates (P < 0.005).

Conclusions:

  • Sevoflurane causes more immediate postoperative distress than halothane in children.
  • This initial difference in distress does not result in sustained negative behavioral changes.
  • Decreasing age is a significant risk factor for negative behavioral changes following pediatric surgery.
Abstract

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