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Changes in sensory processing after anesthesia in toddlers
Johan M Berghmans1,2,3, Marten J Poley4,5, Jan van der Ende6
1Department of Anesthesia, ZNA Middelheim, Queen Paola Children's Hospital, Antwerp, Belgium - j.berghmans@erasmusmc.nl.
Insights
Pediatric anesthesia and surgery alter toddlers' sensory processing. Pre-existing emotional and behavioral issues increase vulnerability to these sensory changes post-operation.
Area of Science:
- Pediatric Anesthesiology
- Developmental Psychology
- Sensory Processing Research
Background:
- Anesthesia and surgery can impact sensory processing in toddlers.
- Postoperative adjustment and behavior may be affected by these sensory changes.
Purpose of the Study:
- To assess pre- to postoperative changes in sensory processing in toddlers after anesthesia.
- To identify predictors of sensory processing alterations in young children undergoing surgery.
Main Methods:
- Prospective cohort study of 70 healthy boys aged 18-30 months undergoing circumcision.
- Utilized the Infant/Toddler-Sensory Profile (ITSP7-36) to measure sensory processing changes.
- Assessed preoperative emotional/behavioral problems, state anxiety, and postoperative pain as predictors.
Main Results:
- Significant changes observed in sensory processing domains including low registration, sensory sensitivity, sensation avoiding, low threshold, auditory, and tactile processing.
- Higher preoperative emotional/behavioral problem scores predicted greater sensory processing changes.
- 45 boys completed assessments at both pre- and postoperative time points.
Conclusions:
- Toddlers exhibit altered sensory processing following anesthesia and surgery.
- Children with pre-existing emotional/behavioral problems are more susceptible to anesthesia-induced sensory processing changes.
Background:
Anesthesia and surgery may influence toddlers' sensory processing and consequently postoperative adjustment and behavior. This is the first study to: 1) test pre- to postoperative changes in sensory processing after pediatric anesthesia using the validated Infant/Toddler-Sensory Profile for 7-36 months (ITSP7-36); 2) identify putative predictors of these changes.
Methods:
This prospective cohort study included 70 healthy boys (ASA I & II), aged 18-30 months, who underwent circumcision for religious reasons. Exclusion: boys with prior surgery and known developmental delay.
Primary Outcome:
changes in sensory processing from the day of admission to day 14 postoperatively. The accompanying parent completed the ITSP7-36. Putative predictors: 1) child's preoperative emotional/behavioral problems; 2) child's state anxiety at induction; 3) postoperative pain at home. All children received standardized anesthesia and pain management.
Results:
For 45 boys, assessments were completed at both time points. Significant changes in sensory processing (mean ITSP7-36 scores) were found on: low registration (47.5 to 49.8; P=0.015), sensory sensitivity (45.2 to 48.0; P=0.011), sensation avoiding (48.2 to 51.3; P=0.010), low threshold (93.4 to 99.4; P=0.007), auditory processing (39.3 to 43.3; P=0.000) and tactile processing (53.9 to 58.4; P=0.002). Higher scores on emotional/behavioral problems predicted changes on sensory processing.
Conclusions:
Sensory processing of these toddlers had changed after anesthesia. Children with more pre-existent emotional/behavioral problems are more vulnerable to these changes.
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