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The postoperative effect of sevoflurane inhalational anesthesia on cognitive function and inflammatory response of
1Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, Jiangsu, P.R. China. fanconghai020@163.com.
Insights
Prolonged sevoflurane anesthesia in children increases the risk of postoperative cognitive dysfunction (POCD). Higher levels of caspase-3, TNF-α, and IL-6 are linked to POCD after longer anesthesia durations.
Area of Science:
- Pediatric Anesthesiology
- Neuroinflammation
- Cognitive Science
Background:
- General anesthesia is essential for pediatric surgery.
- Postoperative cognitive dysfunction (POCD) is a concern in children.
- Sevoflurane is a common anesthetic agent.
Purpose of the Study:
- To examine sevoflurane's impact on pediatric cognitive function.
- To assess the inflammatory response in children post-anesthesia.
- To correlate anesthesia duration with cognitive and inflammatory changes.
Main Methods:
- Ninety-three pediatric patients were grouped by anesthesia duration (<1h, 1-3h, ≥3h).
- Cognitive function and serum inflammatory markers (caspase-3, TNF-α, IL-6) were evaluated.
- Comparisons were made between groups and POCD/non-POCD subgroups.
Main Results:
- POCD occurred more frequently in children with anesthesia ≥3 hours (Group C).
- Elevated caspase-3, TNF-α, and IL-6 levels were observed in the POCD group.
- Inflammatory markers peaked during the recovery period in POCD patients.
Conclusions:
- Extended sevoflurane anesthesia (≥3 hours) increases POCD risk in children.
- Serum caspase-3, TNF-α, and IL-6 levels are associated with prolonged anesthesia and POCD.
- Anesthesia duration is a critical factor influencing pediatric postoperative outcomes.
Objective:
To investigate the effect of sevoflurane on cognitive function and inflammatory response of children after general anesthesia at different times.
Patients And Methods:
Ninety-three pediatric patients who underwent general anesthesia surgery were enrolled and divided into groups based on time under general anesthesia: group A (<1 h, n=27), group B (1-3 h, n=36), and group C (≥ 3 h, n=30). Changes in cognitive function and serum inflammatory index were compared.
Results:
The occurrence of postoperative cognitive dysfunction (POCD) in group A and B was lower than in group C and the difference was statistically significant (p<0.05). The levels of caspase-3, TNF-α, and IL-6 in the POCD group at the different time points were significantly higher than in the non-POCD group and the differences were statistically significant (p<0.05). Caspase-3, TNF-α, and IL-6 levels in the POCD group at the different time points significantly changed and were highest during the recovery period, while there were no significant changes in the non-POCD group at the different time points.
Conclusions:
The prolonged sevoflurane inhalational anesthesia time (≥ 3 h) enhanced the occurrence of POCD and was related to the expression levels of serum caspase-3, TNF-α, and IL-6.
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