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Longitudinal assessment of behaviour in young children undergoing general anaesthesia
Yu Shi1, Sarah Macoun2, Andrew C Hanson3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Insights
General anesthesia for elective surgery in young children showed a slight decrease in internalizing behaviors at three months post-operation. No significant changes were observed in other behavioral areas, even with prior anesthesia exposure.
Area of Science:
- Pediatric Anesthesiology
- Developmental Psychology
- Child Behavior
Background:
- General anesthesia in children may be linked to long-term behavioral issues.
- Short-term behavioral changes post-anesthesia require further investigation for long-term implications.
Purpose of the Study:
- To assess the short-term behavioral trajectory in young children (2.5-6 years) after general anesthesia for elective surgery.
- To evaluate parent-reported behaviors using the Behavior Assessment System for Children, third edition (BASC-3).
Main Methods:
- Recruited 68 children (37 girls) undergoing general anesthesia for elective surgery.
- Assessed behavior preoperatively and 3 months postoperatively using BASC-3.
- Employed linear mixed models to analyze longitudinal changes in parent-reported behavior.
Main Results:
- A statistically significant decrease in T scores for internalizing problems (-2.7), anxiety (-2.5), and somatization (-3.0) was observed at 3 months post-anesthesia.
- No significant differences were found in other behavioral composites or scales.
- Results remained consistent regardless of prior anesthesia exposure.
Conclusions:
- General anesthesia for elective surgery in young children was associated with a minor reduction in internalizing problems at 3 months postoperatively.
- No significant changes in other behavioral domains were detected, irrespective of previous anesthesia exposure.
Background:
Exposure to general anaesthesia in children might increase the risk of long-term behavioural problems. It is unclear if any behavioural changes in the short term after anaesthesia could be associated with long-term problems. The goal of the current study was to evaluate the short-term trajectory of parent-reported behaviour measured by the Behaviour Assessment System for Children, third edition (BASC-3) amongst children aged 2.5-6 yr who underwent general anaesthesia for elective surgery.
Methods:
Children who were undergoing general anaesthesia for surgery were recruited for assessment of behaviour on two occasions: preoperatively (from 1 week to 1 day before anaesthesia), and 3 months postoperatively. To assess longitudinal changes in the parent-reported behaviour measured by BASC-3, linear mixed models were built with visit number included as a categorical variable and subject-specific random intercepts.
Results:
Sixty-eight children (37 girls [54%]) were enrolled in the study and completed both assessments. At 3 months after anaesthesia, statistically significant improvements (decrease in T scores) in internalising problems (-2.7 [95% confidence interval -4.2 to -1.1]), anxiety (-2.5 [-4.4 to -0.5]), and somatisation (-3.0 [-5.2 to -0.9]) were found. There were no significant differences in scores between visits for other composites or scales. The pattern of results did not depend upon prior anaesthesia exposure.
Conclusions:
Anaesthesia for elective surgery in young children was associated with a small decrease in internalising problems but no changes in other areas of behavioural problems when assessed at 3 months postoperatively, including in children with prior exposure to anaesthesia.
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