The association between attention deficit hyperactivity disorder and general anaesthesia - a narrative review

Attention deficit hyperactivity disorder is a chronic neurodevelopmental disorder, manifesting primarily as attention deficit, hyperactivity and impulsive behaviour. General anaesthetics can be neurotoxic, affecting neuronal differentiation and synaptogenesis, which can lead to abnormalities of cognition, learning and behaviour. We hypothesise that exposure of the immature brain to general anaesthetics predisposes to the development of attention deficit hyperactivity disorder. In this review, we summarise clinical and animal studies that relate attention deficit hyperactivity disorder to general anaesthesia, by actions on neural molecular mechanisms and neural networks. We also describe potential therapeutic approaches to modulate these effects.