title: The effects of brief sevoflurane-nitrous oxide anaesthesia upon children's postoperative cognition and behaviour.
abstract: This study assessed the effects of brief sevoflurane-nitrous oxide anaesthesia on children's postoperative cognition, behaviour and physical morbidity. Forty-eight children aged 5-10 years undergoing anaesthesia without premedication for multiple dental extractions, and 48 control children, performed tests of choice reaction time, attention, psychomotor co-ordination and memory pre-operatively (baseline), prior to discharge and at 48 h (anaesthesia group only). Physical and psychological morbidity were recorded at 1 week. Mean choice reaction time and psychomotor co-ordination were significantly impaired postoperatively but had recovered at 48 h. However, measures of performance variability suggested the presence of residual impairment. Profound retrograde amnesia affected postoperative and 48-h recall of pictorial stimuli presented prior to anaesthesia, but recognition memory was unimpaired. Attention-seeking, tantrums, crying and nightmares were occurring more frequently in some 8-20% of children 1 week after the procedure.
authors.affiliation: University Section of Psychological Medicine, Gartnavel Royal Hospital, Glasgow, UK. k.millar@clinmed.gla.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Millar
authors.forename: A J
authors.initials: AJ
authors.lastname: Asbury
authors.forename: A W
authors.initials: AW
authors.lastname: Bowman
authors.forename: M T
authors.initials: MT
authors.lastname: Hosey
authors.forename: T
authors.initials: T
authors.lastname: Musiello
authors.forename: R R
authors.initials: RR
authors.lastname: Welbury
mesh_terms: D000556:Ambulatory Surgical Procedures; D019162:Anesthetics, Combined / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced; D008738:Methyl Ethers / Q000009:adverse effects*; D009483:Neuropsychological Tests; D009609:Nitrous Oxide / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced; D011597:Psychomotor Performance / Q000187:drug effects; D011930:Reaction Time / Q000187:drug effects; D000077149:Sevoflurane; D014081:Tooth Extraction
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide