Longitudinal assessment of behaviour in young children undergoing general anaesthesia

Yu Shi, Sarah Macoun, Andrew C. Hanson, Darrell R. Schroeder, Alexandra C. Kirsch, Kelly M. Haines, Michael J. Zaccariello, David O. Warner

Research output: Contribution to journalArticlepeer-review


Background: Exposure to general anaesthesia in children might increase the risk of long-term behavioural problems. It is unclear if any behavioural changes in the short term after anaesthesia could be associated with long-term problems. The goal of the current study was to evaluate the short-term trajectory of parent-reported behaviour measured by the Behaviour Assessment System for Children, third edition (BASC-3) amongst children aged 2.5–6 yr who underwent general anaesthesia for elective surgery. Methods: Children who were undergoing general anaesthesia for surgery were recruited for assessment of behaviour on two occasions: preoperatively (from 1 week to 1 day before anaesthesia), and 3 months postoperatively. To assess longitudinal changes in the parent-reported behaviour measured by BASC-3, linear mixed models were built with visit number included as a categorical variable and subject-specific random intercepts. Results: Sixty-eight children (37 girls [54%]) were enrolled in the study and completed both assessments. At 3 months after anaesthesia, statistically significant improvements (decrease in T scores) in internalising problems (−2.7 [95% confidence interval −4.2 to −1.1]), anxiety (−2.5 [−4.4 to −0.5]), and somatisation (−3.0 [−5.2 to −0.9]) were found. There were no significant differences in scores between visits for other composites or scales. The pattern of results did not depend upon prior anaesthesia exposure. Conclusions: Anaesthesia for elective surgery in young children was associated with a small decrease in internalising problems but no changes in other areas of behavioural problems when assessed at 3 months postoperatively, including in children with prior exposure to anaesthesia.

Original languageEnglish (US)
Pages (from-to)740-746
Number of pages7
JournalBritish journal of anaesthesia
Issue number5
StatePublished - Nov 2022


  • anaesthesia
  • behaviour
  • children
  • elective surgery
  • internalising problems

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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