Does Exposure to General Anesthesia Have Worsening Effects on ADHD Treatment Efficiency?

Objective: This study aimed to examine whether exposure to general anesthesia (GA) has impairing effects on the pharmacological treatment efficiency in Attention-Deficit/Hyperactivity Disorder (ADHD), and to compare symptoms of inattention (IN), hyperactivity/impulsivity (HI), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) between those exposed, and non-exposed to GA.Method: A total of 106 children with ADHD, aged 7 to 12 years who received pharmacological treatment with methylphenidate or atomoxetine for ADHD and followed up for 3 months were included in the study.An appropriate and standardized dose titration process was applied to all cases.Parents completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disruptive Behavior Disorders Rating Scale questionnaire items at the beginning and at the end of the follow-up period.Information about the children's exposure to GA, frequency of exposures, and age they received GA was obtained from their parents.Results: Both at the beginning and at the end of the follow-up period, exposure to GA, the age at the onset of exposure and the number of exposures were detected to have no significant effect on the decreases in any dimensional symptom counts (IN, HI, ODD and CD) (all p>0.05).However, the symptom counts of HI were found to be significantly higher in children with a history of exposure to GA, those with multiple exposures to GA and younger than 3 years of age than patients not exposed to GA (all p<0.006). Conclusion:Although exposure to GA is associated with ADHD, neither exposure to GA itself, exposures at earlier ages and multiple exposures do not seem to weaken the response to pharmacological treatment of ADHD.However, particularly symptoms of HI may be more vulnerable to adverse effects of GA and related factors.These preliminary findings need to be confirmed by future studies.