Total Intravenous Versus Volatile Anesthesia in Pediatric Cardiac Surgery: Inflammatory Response and Early Recovery...

Area of Science:

• Anesthesiology
• Pediatric Cardiac Surgery
• Neuroscience

Background:

• Pediatric cardiac surgery often involves cardiopulmonary bypass, posing risks for systemic inflammation and neurocognitive deficits.
• Anesthetic choice may influence postoperative outcomes, including inflammation and cognitive function.

Purpose of the Study:

• To compare the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on systemic inflammation and early postoperative cognitive recovery in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass.

Main Methods:

• Prospective, randomized controlled trial involving 50 children (1-12 years) undergoing elective open heart surgery.
• Patients were randomized to propofol-based TIVA or sevoflurane-based volatile anesthesia.
• Systemic inflammation (interleukin-6) and cognitive recovery (pediatric-adapted Mini-Mental State Examination) were assessed postoperatively.

Main Results:

• No significant difference in interleukin-6 levels between TIVA and volatile anesthesia groups.
• Significantly higher Mini-Mental State Examination scores at 24 and 48 hours post-extubation in the TIVA group compared to the volatile group.
• Shorter duration of mechanical ventilation in the TIVA group.

Conclusions:

• While systemic inflammation markers were comparable, TIVA demonstrated superior early cognitive recovery and reduced mechanical ventilation duration.
• These findings suggest potential neuroprotective advantages of TIVA in pediatric cardiac surgery.