Early exposure to general anesthesia may contribute to later attention-deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis of cohort studies - 11/09/24
Abstract |
Study objective |
The association between early childhood exposure to general anesthesia and subsequent risk of developing attention-deficit/hyperactivity disorder remains unknown.
Design |
A systematic review and meta-analysis of cohort studies.
Patients |
Children undergoing general anesthesia.
Interventions |
A comparison of any type of general anesthesia exposure, including total intravenous anesthesia, inhalation general anesthesia, and combined intravenous and inhaled anesthesia, with non-anesthetic exposures, which did not receive any exposure to anesthetic drugs, including general anesthetics as well as local anesthetics.
Measurements |
The primary outcome measure was the risk of developing attention-deficit/hyperactivity disorder after general anesthesia exposure.
Main results |
The results of the overall meta-analysis showed an increased risk of subsequent attention-deficit/hyperactivity disorder in children exposed to general anesthesia (RR = 1.26, 95% CI, 1.16–1.38; P < 0.001; I2 = 44.6%). Subgroup analysis found that a single exposure to general anesthesia in childhood was associated with an increased risk of developing attention-deficit/hyperactivity disorder (RR = 1.29, 95% CI, 1.19–1.40, P < 0.001; I2 = 2.6%), and the risk of attention-deficit/hyperactivity disorder was further increased after multiple general anesthesia exposures (RR = 1.61, 95% CI, 1.32–1.97, P < 0.001; I2 = 57.6%). Exposure to general anesthesia lasting 1–60 min during childhood is associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD) (RR: 1.38, 95% CI: 1.26–1.51, P < 0.001; I2 = 0.0%). Moreover, with longer durations of exposure (61–120 min), the risk further rises (RR: 1.55, 95% CI: 1.21–1.99, P = 0.001; I2 = 37.8%). However, no additional increase in ADHD risk was observed with exposures exceeding 120 min (RR: 1.55, 95% CI: 1.35–1.79, P < 0.001; I2 = 0.0%).
Conclusions |
Exposure to general anesthesia during early childhood increases the risk of developing attention-deficit/hyperactivity disorder. In particular, multiple general anesthesia exposures and exposures longer than 60 min significantly increase the risk of developing ADHD.
Le texte complet de cet article est disponible en PDF.Highlights |
• | General anesthesia exposure in young children associated with developing ADHD. |
• | Multiple or prolonged general anesthesia exposure increases subsequent risk of ADHD. |
• | More prospective studies needed to reveal relationship between general anesthesia exposure and ADHD. |
Keywords : General anesthesia, Attention deficit/hyperactivity disorder, Anesthetic neurotoxicity, Children, Meta-analysis
Abbreviation : GA, ADHD, DSM-IV, ICD, NOS, CI, MOOSE, RR, HR, IQ
Plan
Vol 98
Article 111585- novembre 2024 Retour au numéro
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