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Influence of laryngeal mask airway (LMA) insertion anesthesia on cognitive function after microsurgery in pediatric
1Department of Neonatology, Xuzhou Chlidren's Hospital, Xuzhou, Jiangsu, P.R. China. fanconghai020@163.com.
Objective:
To compare the influence of laryngeal mask airway (LMA) insertion anesthesia and endotracheal intubation on cognitive function during anesthesia for neurosurgery microscopy.
Patients And Methods:
A total of 76 pediatric patients who underwent neurosurgery microscopy were selected. They were randomly divided in the LMA insertion group with 35 cases and the endotracheal intubation group with 41 cases. Before the operation, the two groups were injected with 0.02 mg/kg atropine and 2 mg/kg phenobarbital. A combination solution of 2 mg/kg ketamine and 0.1 mg/kg midazolam was then given to induce anesthesia. The inhalation of 4-6% sevoflurane was used to maintain anesthesia. The hemodynamics, complications, cognitive functions, and expression levels of serum NSE and S-100β protein after anesthesia and extubation were compared.
Results:
After comparing the average heart rate, average arterial pressure and average oxygen saturation of the LMA insertion group at different times, the difference was not statistically significant (p>0.05). At T2 and T4, compared with the endotracheal intubation group, the average heart rate and arterial pressure of the LMA insertion group were significantly reduced and the average oxygen saturation was significantly increased. The difference was statistically significant (p<0.05). The prevalence of complications from postoperative cognitive dysfunction (POCD) of the LMA insertion group was significantly lower than that of the endotracheal incubation group. The difference was statistically significant (p<0.05).
Conclusions:
Compared with the endotracheal intubation group, in the LMA insertion group, the hemodynamics is more stable, the prevalence of postoperative complications and the POCD are lower during pediatric neurosurgery microscopy. The occurrence of POCD is related to the reduction of protein expression levels of NSE and S-100β during serum anesthesia and the recovery period.
Insights
Laryngeal mask airway anesthesia offers more stable hemodynamics and lower rates of postoperative cognitive dysfunction (POCD) compared to endotracheal intubation in pediatric neurosurgery. POCD is linked to reduced NSE and S-100β protein levels.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pediatric Medicine
Background:
- Cognitive function is a critical concern in pediatric neurosurgery.
- Anesthesia methods, including laryngeal mask airway (LMA) insertion and endotracheal intubation, can impact neurological outcomes.
- Understanding the effects of different airway management techniques on cognitive function is essential for patient care.
Purpose of the Study:
- To compare the influence of laryngeal mask airway (LMA) insertion anesthesia versus endotracheal intubation on cognitive function in pediatric patients undergoing neurosurgery.
- To evaluate hemodynamic stability and complication rates associated with each anesthesia technique.
Main Methods:
- A randomized study of 76 pediatric patients undergoing neurosurgery microscopy.
- Patients were divided into LMA insertion (35) and endotracheal intubation (41) groups.
- Anesthesia was induced with ketamine and midazolam, maintained with sevoflurane. Hemodynamics, complications, cognitive function, and serum NSE/S-100β levels were assessed.
Main Results:
- The LMA group exhibited significantly more stable hemodynamics (heart rate, arterial pressure, oxygen saturation) compared to the endotracheal intubation group (p<0.05).
- The incidence of postoperative cognitive dysfunction (POCD) was significantly lower in the LMA group (p<0.05).
- Reduced serum NSE and S-100β protein levels were observed during anesthesia and recovery in patients experiencing POCD.
Conclusions:
- Laryngeal mask airway anesthesia provides superior hemodynamic stability and reduces the incidence of POCD in pediatric neurosurgery compared to endotracheal intubation.
- The findings suggest a correlation between POCD occurrence and altered serum NSE and S-100β protein expression levels.
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