Changes in sensory processing after anesthesia in toddlers

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 (ITSP_7-36); 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 ITS P_7-36. Putative predictors: 1) child' preoperative emotional/behavioral problems; 2) child' 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 ITSP_7-36 scores) were found on: low registration (47.5 to 49.8; P=0.015), sensory sensitivity (45.2 to 48.0; P=0.011), sensation avoiding (48.2 to 51.3; P=0.010), low threshold (93.4 to 99.4; P=0.007), auditory processing (39.3 to 43.3; P=0.000) and tactile processing (53.9 to 58.4; P=0.002). 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.