Intraoperative prevention of cognitive impairment in total intravenous anesthesia in school-age children: randomized clinical trial

Abstract

Objective. To determine the possibility of prophylactic use of the domestic drug Cytoflavin to reduce the incidence of cognitive impairment after total intravenous anesthesia based on propofol and fentanyl in school-age children. Material and methods. A prospective randomized clinical trial involving 90 school-age children (ASA I-II) was conducted. Children operated under total intravenous anesthesia on the basis of propofol and fentanyl were randomized into two groups: intraoperative cerebroprotection with cytoflavine 0.25 mg/kg per minute by succinate was performed in group 1 (n = 30), and no cerebroprotection was performed in group 2 (n = 30). For the Z-assessment of cognitive potential, neuropsychological testing of children of the same age who were not subjected to anesthesia was performed (group 3, n = 30). Research results. There were no significant differences in hemodynamic and neurophysiological parameters in the groups using total intravenous anesthesia based on propofol and fentanyl. Analysis of these parameters showed the safety of the study drug. In the 1 group postoperative cognitive dysfunction (POCD) was detected on the first day of 6.67 % of children, and on the 7^th day of postoperative period - at 3.33 %. In group 2, on the first day of the postoperative period, POCD was verified in 13.79 % ofpatients, on the 7^th day - in 27.59 %. Conclusion. The obtained data showed the effectiveness and safety of the domestic drug cytoflavin as a prophylactic agent of POCD in school-age children with total intravenous anesthesia based on propofol and fentanyl.