Why anesthesia could worsen ADHD
Anesthesia has been shown to cause premature death of brain cells in exposed rats and other animals. Scientists believe that anesthesia could also have the same effect in the brains of humans, especially younger children who are experiencing rapid brain growth and change. Two large studies have demonstrated an association between exposure to anesthesia early in life (before the age of 3 or 4 years old) and increased risk of ADHD. The risk was highest for children who had multiple exposures to anesthesia or for longer lengths of exposure ( more than 3 hours). These studies did control for a number of possible confounding factors: other neurological diseases (such as seizures and tics), the types of surgery, prematurity, etc.
What the research does NOT tell us
The studies done still do not prove causation. While the studies were thorough in controlling for confounding factors, it is possible that something was missed. For example, patients with ADHD may be more likely to undergo surgery and get anesthesia due to being accident prone.
Most of these studies were done on children who had surgery very early in life--earlier than ADHD is typically diagnosed. The studies really do not address the question at all of whether anesthesia later in life has the same effect on ADHD.
These studies focus on the effects of general anesthesia. They do not say anything about epidurals or other forms of local anesthesia. They also do not address sedation.
What you should do if you are considering anesthesia and you have ADHD
- Don't get unnecessary procedures done. "Unnecessary" here means a procedure whose purpose is primarily cosmetic, or which would result in information that would not change the course of treatment.
- Don't get general anesthesia unless it is necessary. For example, at the dentist's office, if you can manage with a mild sedative, or just Novocaine, then don't go for laughing gas.
- If the procedure can safely wait until after age 5, then it may be best to wait. However, if there are risks to waiting, it is probably better to get the procedure done in a timely fashion, since the risk of anesthesia toward ADHD is still theoretical at this time.
- Any procedure which is medically necessary at any time should not be denied to a patient solely on the basis of their ADHD. Patients should always weigh the benefits of the procedure against its risks and not focus solely on risks.
- Always inform your anesthesia professional and the doctor ordering the procedure of your ADHD diagnosis and your concerns about anesthesia's risks to cognitive function.
References:
Ko, Wen-Ru, Yung-Po Liaw, Jing-Yang Huang, De-Hui Zhao, Hui-Chin Chang, Pei-Chieh Ko, Shiou-Rung Jan, Oswald Ndi Nfor, Yi-Chen Chiang, and Long-Yau Lin. "Exposure to General Anesthesia in Early Life and the Risk of Attention Deficit/hyperactivity Disorder Development: A Nationwide, Retrospective Matched-cohort Study." Pediatric Anesthesia Paediatr Anaesth 24.7 (2014): 741-48. Web.
Sprung, Juraj, Randall P. Flick, Slavica K. Katusic, Robert C. Colligan, William J. Barbaresi, Katarina Bojanić, Tasha L. Welch, Michael D. Olson, Andrew C. Hanson, Darrell R. Schroeder, Robert T. Wilder, and David O. Warner. "Attention-Deficit/Hyperactivity Disorder After Early Exposure to Procedures Requiring General Anesthesia." Mayo Clinic Proceedings 87.2 (2012): 120-29. Web.
Tsai, C.-J., C. T.-C. Lee, S. H.-Y. Liang, P.-J. Tsai, V. C.-H. Chen, and M. Gossop. "Risk of ADHD After Multiple Exposures to General Anesthesia: A Nationwide Retrospective Cohort Study." Journal of Attention Disorders (2015): n. pag. Web.
Everything ADHD Medical Disclaimer
Everything ADHD Privacy Policy
No comments:
Post a Comment