Behaviour changes in children after general anaesthetic for tonsil surgery

[Tryingmybestmummying]

Hi
I have 2 boys who went under general anaesthetic for tonsillitis. My first DS came out kicking and screaming and I felt he has never comeback to his usual self. It’s almost 2 years post operation. At the time he was 5 years old. Since then he gets frustrated easily and screams.
My second DS just had his operation 3 weeks ago. I was worried that the same might happen. My 2 years old was calm and never shouted or screamed but now every time he is put in his car seat, he screams. He shouts a lot and is not his usual self. I’m at loss, sad and feel lonely. Is this only happen to me? Do I still have hope that my DS2 would come back to his calm nature? I mentioned this concern to nurses and doctors but they just told me to take my DS1 to GP. Please share your story of your love one after general anaesthetic.

It takes a month for GA to fully leave your body (at least, I was told this when I had one) so it's early days for your 2 yo. Maybe DS1 would benefit from some sort of therapy?

Post op behavioural changes aren’t wildly uncommon but do usually improve in a few weeks. 2 yrs of changes would be unusual & might make you wonder if there was anything else contributing to the behaviour.

post op changes are more common in the under 5s, anxious kids (plus anxious parents) & iirc if a sibling’s been the same. It’s a post-operative phenomenon rather than a specifically post-anaesthetic problem.

Thank you for your replies. The more I read the more I believe anaesthetic messes up brains especially younger and older people. I know they both needed the surgery but I still feel sad about the outcome how they have changed. I hope my 2 years old will recover. It’s just devastating to see him changing at the moment.

I doubt the two things are directly linked, it might be that before the operation they were more frequently unwell and tired so less likely to kick off.

My dd had her tonsils out when she was 4yo, she was subdued for a week or so but then back to her normal self.

It isn’t just to do with the anaesthetic ‘messing up’ their brains - it’s to do with the response to the operation (one small part of which is the anaesthetic), anxiety, pain, being in an unfamiliar environment etc. It’s a complex problem. Presumably the 2 yr old had their tonsils done in a tertiary centre so they’re quite likely to have access to support for this sort of problem & it may be worth getting back in touch if you’re worried. (Doi fwiw: anaesthetist)

I have had more surgeries then i can count and G.A always effects my mood but only for a couple of weeks then im fine again. I doubt after 2 years thats what's causing the issue

'I believe anaesthetic messes up brains' - Belief is a powerful thing. Priests once believed women who used herbs for pain relief were witches and burned them alive. Fortunately, we've moved on from relying solely on belief and now have science and evidence to guide us. You might find them useful.

Sounds like trauma
he would have been too young to understand what was happening and felt really out of control
So if he feels out of control again he gets scared and lashes out

Whoever told you it, it's not true. A surgeon isn't an anaesthetist, and there's an actual anaesthetist on this thread.

Both my DC had about a dozen general anaesthetics each before age 3, so that they could have eye examinations as hereditary eye cancer runs in the family (fortunately neither of them had it). Possibly those weren’t as powerful as the GA you’d have for actual surgery, but nevertheless while they did both scream their poor little hearts out when they were coming round from them, there was no change in their personalities or behaviour afterwards.

I wonder if you are seeing correlation with behaviour that would have developed naturally at those ages anyway and assuming it’s causation? Or you have responded to behaviour is a different way than you might have done if you weren’t blaming the after effects of the GAs? or your 5 YO could still have some traumatic memories that maybe some play therapy of similar would help with? Your 2 year old won’t remember, although if the surgery was recent he may still be in pain and that could be affecting his behaviour.

Hang in there - I’m sure it will get better.

I know what a troll is, and your other posts are equally rude and unhelpful. If you can't be nice, just scroll on by.

Tbf, you are the one posting inaccurate information and then doubling down (nastily) when called out 🤷‍♀️

Did they have any post operative infections - look at Pans Pandas.

Did they have nitrous oxide- look at b12 deficiency.

When I expressed my concerns to the anaesthetist who will look after my DS2, she told me the same. It would take a month for GA to fully leave your body, in some cases around 6 months but not 1 year. I was told to consult with GP as my DS1 is now 2 years after his operation.

I was worried and read a lot scientific papers but the algorithm feeds you what you look for isn’t it?

I need to be patient it might take a month hopefully not 6 months.

thank you for the suggestion regarding post operative infections! It’s been 2 days I smell as if when he was on day 4-5. Not as strong but I smell something. Will look at b12 as well! Thank you!

It is definitely traumatic. I’ve never thought about it in this way. Thank you!

Nitrous isn’t used that often in anaesthetics these days, but even when it is, therapeutic use in this sort of context is unlikely to cause B12 related problems. Repeat exposure/long duration exposure is the problem (which is why staff are most at risk in a medical setting).

It depends if the child already had low b12 without this being picked up on tests.

Do you have a link to the evidence for that?

There are a large number of papers - I'm afraid I don't have time to Google it for you thoroughly but you will find it pretty easy to do.
Briefly, the government advice highlights the risks of even one exposure to nitrous oxide for people with risk of low B12.

https://www.gov.uk/drug-safety-update/nitrous-oxide-neurological-and-haematological-toxic-effects

Research also shows that brief exposure (even 2+ hours) to nitrous oxide during general anesthesia causes a significant spike in postoperative homocysteine in young children, indicating B12 pathway disruption. For children with normal B12 reserves, this is usually temporary and well-tolerated, but it poses a danger for those with subclinical deficiencies.

https://pubmed.ncbi.nlm.nih.gov/22584536/

The challenge is, though, that many of our children have undiagnosed b12 deficiency which doctors are completely unable to diagnose and treat. The associated methylation problems and iron deficiencies in children are not really well understood and our children in this country are already woefully under-treated for the serious conditions of occult anaemia and nerve damage caused by poor processing of B12. The treatment is extremely simple.

I'm now at the point where I think every autistic, anxious, Adhd, dyspraxic child should be given injections of b12 every other day for 6 months as standard. Cheap, safe, no danger of overdose, would probably resolve so many neurological and physical symptoms. No autistic children sleep at night. What's the root cause of that? For many it might be the nerve damage, neurological problems, anxiety and restless legs of iron deficiency and low B12.

So yeah I would never give a child with any hint of those kinds of issues a gas anaesthetic. Why do it when there are alternatives out there.