Psychological trauma after anaesthesia in children is recognised but often underestimated. Forced induction, though sometimes used under time pressure, may lead to long-term effects including post-traumatic stress disorder (PTSD). A boy in middle childhood required surgery for a fractured arm. He expressed fear of masks. His mother revealed a past surgical procedure under general anaesthesia, which the child did not recall. Despite a preoperative consultation, he became distressed and uncooperative. Anaesthesia was forcibly induced using restraint. He later developed PTSD symptoms (nightmares, separation anxiety and hypervigilance), without receiving psychiatric care. At our institution, we used a trauma-informed, child-centred approach: shared decision-making, preoperative desensitisation, topical anaesthesia for intravenous access and emotional support. Surgery proceeded without complications or psychological distress postoperatively or at 6-day follow-up. This case highlights the risk of psychological harm from forced anaesthesia and supports trauma-informed care to prevent retraumatisation and reduce long-term mental health consequences.
Schneider et al. (Thu,) studied this question.