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[Intraoperative cerebroprotection in total intravenous anesthesia in children of school age]
A M Ovezov1, M V Panteleeva1, A V Lugovoy1
1Vladimirsky Moscow Regional Clinical Research Institute, Moscow, Russia.
Insights
Intraoperative metabolic-mediated cerebroprotection using cytoflavin effectively reduced postoperative cognitive dysfunction (POCD) in school-age children undergoing propofol-based anesthesia. This intervention significantly lowered the incidence of POCD compared to standard anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Neurology
- Pharmacology
Background:
- Total intravenous anesthesia with propofol is widely used in pediatric surgery.
- Postoperative cognitive dysfunction (POCD) is a potential complication in children following anesthesia.
- Metabolic-mediated cerebroprotection strategies are being explored to mitigate neurological deficits.
Purpose of the Study:
- To evaluate the efficacy of intraoperative metabolic-mediated cerebroprotection with cytoflavin in preventing POCD in school-age children.
- To assess the impact of cytoflavin on cognitive function following propofol-based total intravenous anesthesia.
Main Methods:
- A randomized, prospective, longitudinal clinical study involved 60 school-age children undergoing surgery under propofol anesthesia.
- Children were divided into two groups: one receiving standard anesthesia and the other receiving cytoflavin for cerebroprotection.
- Neuropsychological testing was used to assess cognitive function pre- and post-operatively, with a control group of 30 non-surgically treated children.
Main Results:
- Postoperative cognitive dysfunction (POCD) was observed in 13.79% of the control group on day 1 and 26.67% on day 7.
- In the cytoflavin group, POCD incidence was significantly lower: 6.67% on day 1 and 3.33% on day 7 (p=0.009).
- These findings indicate a protective effect of cytoflavin against POCD.
Conclusions:
- Intraoperative administration of cytoflavin is effective in preventing postoperative cognitive dysfunction in school-age children.
- Metabolic-mediated cerebroprotection with cytoflavin improves neurological outcomes after propofol anesthesia.
- Cytoflavin represents a promising therapeutic option for reducing cognitive impairment in pediatric surgical patients.
Aim:
To improve the quality of anesthesia in school-age children by using intraoperative metabolic-mediated cerebroprotection to reduce the incidence of cognitive impairment after total intravenous anesthesia based on propofol.
Material And Methods:
A randomized, prospective, longitudinal clinical study was conducted, involving 60 school-age children operated under total intravenous anesthesia on the basis of propofol. Children were randomized into two equal groups. Patients of the 1st group did not receive intraoperative metabolic-mediated cerebroprotection, patients of the 2nd group were treated with cytoflavin. For Z-assessment of changes in cognitive potential, neuropsychological testing of 30 children of the same age who were not subjected to surgical intervention was performed.
Results And Conclusion:
On the 1st day of the postoperative period, 13.79% of patients of the 1st group had postoperative cognitive dysfunction (POCD), on the 7th day, POCD was observed in 26.67% of children. In the 2nd group, POCD was detected in 6.67% and 3.33% of patients on the 1st and 7th day, respectively (p=0,009). The results confirm the efficacy of cytoflavin in intraoperative prevention of POCD in school-age children.
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