Behavioral and emotional effects of repeated general anesthesia in young children

Preclinical and clinical data suggest the possibility of neurotoxicity following exposure of young children to general anesthetics with subsequent behavioral disturbances. The aim of the study was to determine the overall effect of repeated general anesthesia on behavior and emotions of young children aged 1½-5 years old, compared to healthy children. Thirty-five children underwent repeated anesthesia and surgery were matched with the same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist [CBCL] 1½-5 years and Diagnostic and Statistical Manual of Mental Disorders [DSM] oriented scale. Behavior data were collected through a semi-structured questionnaire. The CBCL score revealed that children with repeated anesthesia were at risk to become anxious or depressed [relative risk [RR]; 95% confidence interval [CI] = 11 [1.5-80.7]], to have sleep [RR; 95% CI = 4.5 [1.1-19.4]], and attention problems [RR; 95% CI = 8 [1.1-60.6]]. There was no difference in the risk between the two groups regarding emotionally reactive, somatic complaints, withdrawn problems, aggressive behavior, internalizing or externalizing problems. On DSM scale, children with repeated anesthesia were at risk to develop anxiety problems [RR; 95% CI = 3.7 [1.1-12.0]], and attention deficit/hyperactivity problems [RR; 95% CI = 3 [1.1-8.4]]. There was no difference in the risk between the two groups regarding affective, pervasive developmental and oppositional defiant problems. Young children who undergone repeated surgical procedures under general anesthesia were at risk for subsequent behavioral and emotional disturbances. Proper perioperative pain management, social support, and avoidance of unpleasant surgical experiences could minimize these untoward consequences

Behavioral impact of sickle cell disease in young children with repeated hospitalization

Sickle cell disease [SCD] in children with a history of repeated hospitalization is distressing for children as well as their parents leading to anxiety and has negative effects on the psychological state of children and their families. The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1½ to 5 years old who had repeated history of hospitalization, compared to a control group of healthy children attended a vaccination clinic. Thirty-five children of age 1½ to 5 years who have SCD and repeated history of hospitalization were recruited from pediatric clinic as the study group and matched with same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist [CBCL] 1½ to 5 years and diagnostic and statistical [DSM]-oriented scale. Behavior data were collected through a semi-structured questionnaire. Children who have SCD had statistically significant behavioral changes on CBCL compared to the control group: Anxiety/depression [65.2 vs. 55.1; P < 0.001], somatic complaint [66.7 vs. 54.4; P < 0.001] withdrawn [63.4 vs. 53.2; P < 0.001], aggressive behavior [60.4 vs. 56; P=0.04], and internalizing symptoms [64.7 vs. 51.5; P< 0.001], respectively. The DSM scale showed that children with SCD scored significantly higher in pervasive developmental disorder compared to the control group [60.9 vs. 53.9; P < 0.001] respectively. Children with SCD who had history of repeated hospitalization are at an increased risk of developing behavioral problems. Psychological counseling, social support, and proper pain management could minimize these behavioral consequences