Section - CAP Smart Takes

04. Early Childhood General Anesthesia and Risk of ADHD

Published on November 1, 2023 Certification expiration date: November 1, 2026 DOI: 10.64239/PI-CAPST1604

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Children aged 0–3 years exposed to general anesthesia demonstrated a higher risk of ADHD compared with those not exposed.
The frequency of anesthesia exposure showed a correlation with ADHD risk, with longer durations and multiple exposures amplifying the risk.
Although the study suggests a strong association between early anesthesia exposure and ADHD risk, establishing causality remains elusive due to possible confounding variables.

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Hi! David Rosenberg for the CAP Smart Take. In this Smart Take, we examine a potentially significant relationship — that is, early childhood exposure to general anesthesia and the risk of developing ADHD. ADHD is prevalent during childhood and adolescence—more so than previously thought. It persists into adulthood, making adult ADHD a growing yet understudied area in psychiatry. To truly understand adult ADHD, we must delve into its antecedents in childhood and adolescence.

A pivotal study brought to light intriguing questions rather than answers. The researchers probed whether young children requiring general anesthesia for diverse conditions and surgeries had an increased risk of ADHD. Impressively, this was a population-based cohort study, including over 15,000 children aged 0–3 years who were hospitalized for more than 1 day between 2004–14 after receiving general anesthesia. A nonexposed group, those who didn’t receive anesthesia, served as a comparison. Both groups had 7,536 patients. The

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05. Association of Benzodiazepines With Drug Overdose Risk Among Young People

Learning Objectives:

Recognize that psychostimulants had a higher overall rate of adverse events than alpha-2 adrenergic agents in preschool children with ADHD.
Identify that exposure to ADHD medication during pregnancy does not increase the risk of ADHD or autism spectrum disorder.
Evaluate the potential benefits and limitations of adjunctive therapies, such as fish oil, in treating major depressive disorder.
Discuss the potential link between early childhood anesthesia exposure and subsequent ADHD risk.
Recognize that there is an increased risk of drug overdose when benzodiazepines are used for sleep disorders in youth.

Original Release Date: November 1, 2023

Review and Re-release Date: March 1, 2024

Last Review Date: April 1, 2026

Expiration Date: November 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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