Postoperative behavioral changes following anesthesia with sevoflurane.
BACKGROUND
Behavioral disturbance following hospitalization is a relatively frequent event, some children still having negative behavioral changes (NBC) 1 month following their operation. Sevoflurane has a propensity to induce 'excitement' during induction of anaesthesia, and delirium in the immediate postoperative phase. The aim of this study was to evaluate whether this translates into prolonged behavioral change.


METHODS
A total of 120 children presenting for daycase surgical procedures under anesthesia were included in the study. Children were randomized to induction and maintenance of anesthesia with sevoflurane or halothane. No additional sedative drugs were administered. Postoperative behavioral change was assessed using the Post-Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 7 and 30.


RESULTS
The Sevoflurane group (n = 63) were more distressed on emergence of anesthesia than the Halothane group (n = 57) (P < 0.05). About 58.3, 46.8 and 38.3% of all children exhibited NBC on postoperative days 1, 7 and 30, respectively. There was no association between anesthetic agent and behavior. There was a significant relationship between decreasing age and NBC (P < 0.005).


CONCLUSIONS
Children anesthetized with sevoflurane exhibit more immediate postoperative distress than those anesthetized with halothane. This difference is not carried over into the longer posthospital period. Negative behavioral changes occur more frequently with decreasing age.
Keaney
Aideen
A
Department of Anaesthesia & Critical Care Medicine, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Diviney
Dara
D
Harte
Sinead
S
Lyons
Barry
B
D000367:Age Factors; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001519:Behavior / Q000187:drug effects*; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D011595:Psychomotor Agitation / Q000453:epidemiology; D000077149:Sevoflurane; D011795:Surveys and Questionnaires
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane