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The effects of brief sevoflurane-nitrous oxide anaesthesia upon children's postoperative cognition and behaviour

K Millar1, A J Asbury, A W Bowman

  • 1University Section of Psychological Medicine, Gartnavel Royal Hospital, Glasgow, UK. k.millar@clinmed.gla.ac.uk

Anaesthesia
|May 18, 2006
PubMed

Insights

Brief sevoflurane-nitrous oxide anesthesia may impair children's postoperative cognition and behavior, with some residual effects and increased psychological morbidity observed a week later. Further research is needed to understand long-term impacts.

Area of Science:

  • Pediatric Anesthesiology
  • Neuroscience
  • Child Psychology

Background:

  • Anesthesia can impact neurodevelopment in children.
  • Understanding cognitive and behavioral effects of common anesthetic agents is crucial.

Purpose of the Study:

  • To assess the effects of sevoflurane-nitrous oxide anesthesia on children's postoperative cognition, behavior, and physical morbidity.
  • To evaluate recovery of cognitive functions at 48 hours post-anesthesia.

Main Methods:

  • 48 children (5-10 years) undergoing dental extractions with sevoflurane-nitrous oxide anesthesia were compared to 48 controls.
  • Cognitive tests (reaction time, attention, memory, psychomotor coordination) were administered pre-operatively, pre-discharge, and at 48 hours.
  • Physical and psychological morbidity were assessed at 1 week.

Main Results:

  • Choice reaction time and psychomotor coordination were impaired postoperatively, recovering by 48 hours, but with residual variability.
  • Profound retrograde amnesia for pre-anesthesia stimuli was observed, while recognition memory remained intact.
  • Increased attention-seeking, tantrums, crying, and nightmares were reported in 8-20% of children at 1 week.

Conclusions:

  • Brief sevoflurane-nitrous oxide anesthesia can cause temporary cognitive deficits and retrograde amnesia in children.
  • A subset of children experiences behavioral changes and psychological morbidity up to one week post-procedure.
  • While some cognitive functions recover, residual effects and behavioral changes warrant further investigation into long-term neurodevelopmental outcomes.

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