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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 Feb 05

DOI: 10.23736/S0375-9393.18.12132-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Changes in sensory processing after anesthesia in toddlers

Johan M. BERGHMANS 1, 2, 3 , Marten J. POLEY 4, 5, Jan van der ENDE 2, Andre RIETMAN 2, Inge GLAZEMAKERS 6, 7, Dirk HIMPE 1, Frank C. VERHULST 2, 8, Elisabeth UTENS 2, 9

1 Department of Anesthesia, ZNA Middelheim, Queen Paola Children’s Hospital, Antwerp, Belgium; 2 Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children’s Hospital, Rotterdam, The Netherlands; 3 Department of Anesthesia, Erasmus MC, Sophia Children’s Hospital, Rotterdam, The Netherlands; 4 Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands; 5 Department of Pediatric Surgery, Erasmus MC , Sophia Children’s Hospital, Rotterdam, The Netherlands; 6 Collaborative Antwerp Psychiatric Research Institute, University Antwerp, Antwerp, Belgium; 7 University Centre Child and Adolescent Psychiatry, ZNA Middelheim, Antwerp, Belgium; 8 Department of Child and Adolescent Psychiatry, University of Copenhagen, Copenhagen, Denmark; 9 Research Institute of Child Development and Education, University of Amsterdam/de Bascule, Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands


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BACKGROUND: Anesthesia and surgery may influence toddlers’ sensory processing and consequently postoperative adjustment and behavior. This is the first study to: 1. test pre- to postoperative changes in sensory processing after pediatric anesthesia using the validated Infant/Toddler-Sensory Profile for 7-36 months (ITSP7-36); 2. identify putative predictors of these changes.
METHODS: This prospective cohort study included 70 healthy boys (ASA I & II), aged 18- 30 months, who underwent circumcision for religious reasons. Exclusion: boys with prior surgery and known developmental delay. Primary outcome: changes in sensory processing from the day of admission to day 14 postoperatively. The accompanying parent completed the ITSP7-36. Putative predictors: 1. child’s preoperative emotional/behavioral problems; 2. child’s state anxiety at induction; 3. postoperative pain at home. All children received standardized anesthesia and pain management.
RESULTS: For 45 boys, assessments were completed at both time points. Significant changes in sensory processing (mean ITSP7-36 scores) were found on: low registration (47.5 to 49.8; p = .015), sensory sensitivity (45.2 to 48.0; p = .011), sensation avoiding (48.2 to 51.3; p = .010), low threshold (93.4 to 99.4; p = .007), auditory processing (39.3 to 43.3; p = .000) and tactile processing (53.9 to 58.4; p = .002). Higher scores on emotional/behavioral problems predicted changes on sensory processing.
CONCLUSIONS: Sensory processing of these toddlers had changed after anesthesia. Children with more pre-existent emotional/behavioral problems are more vulnerable to these changes.


KEY WORDS: Anesthesiology - Anxiety - Infant - Postoperative Pain - Problem Behavior - Sensation

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Publication History

Article first published online: February 05, 2018
Manuscript accepted: January 26, 2018
Manuscript revised: December 14, 2017
Manuscript received: April 11, 2017

Cite this article as

Berghmans JM, Poley MJ, van der Ende J, Rietman A, Glazemakers I, Himpe D, et al. Changes in sensory processing after anesthesia in toddlers. Minerva Anestesiol 2018 Feb 05. DOI: 10.23736/S0375-9393.18.12132-8

Corresponding author e-mail

j.berghmans@erasmusmc.nl