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Anesthesia induction, emergence, and postoperative behaviors in children with attention-deficit/hyperactivity

Alan R Tait1, Terri Voepel-Lewis, Constance Burke

  • 1Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI 48109, USA. atait@umich.edu

Paediatric Anaesthesia
|May 18, 2010
PubMed

Insights

Children with attention-deficit/hyperactivity disorder (ADHD) experienced more difficulties during anesthesia induction and showed increased postoperative behavioral issues compared to their peers. These findings highlight the need for tailored care in pediatric anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Neurodevelopmental Disorders
  • Behavioral Science

Background:

  • Increasing prevalence of attention-deficit/hyperactivity disorder (ADHD) in pediatric populations.
  • Anesthesiologists encounter more children with ADHD undergoing surgical procedures.
  • Need for understanding perioperative behavioral differences in children with ADHD.

Purpose of the Study:

  • To prospectively compare anesthesia induction, emergence, and postoperative behaviors in children with and without ADHD.
  • To identify specific behavioral challenges faced by children with ADHD during the perioperative period.
  • To inform clinical practice regarding the anesthetic management of children with ADHD.

Main Methods:

  • Prospective, observational study design.
  • Inclusion of 268 children aged 4-17 years with confirmed ADHD undergoing elective surgery.
  • Matched control group of children without ADHD.
  • Use of established scales for preoperative, induction, and emergence behaviors.
  • Modified Post-Hospital Behavioral Questionnaire for postoperative behaviors via telephone.

Main Results:

  • Children with ADHD demonstrated significantly less cooperation during anesthesia induction (20.9% vs 10.6%, P=0.001).
  • Children with ADHD exhibited significantly greater postoperative maladaptive behaviors compared to controls.
  • Specific postoperative issues in children with ADHD included concentration difficulties, disobedience, impulsivity, poor appetite, and increased temper tantrums.

Conclusions:

  • This is the first prospective study to examine perioperative and postoperative behaviors in children with ADHD.
  • Results alert anesthesiologists to potential induction difficulties.
  • Findings emphasize the likelihood of postoperative behavioral problems at home and school for children with ADHD.
Abstract

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