Abstract
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.