Background

Exposure to general anaesthesia in children may be related to deficits in certain areas of cognition. It is unclear if these deficits could be measured in the immediate postoperative period in young children. The goal of the current study was to evaluate the trajectory of cognitive function in the domains of processing speed, working memory, and fine motor skills amongst children aged 2.5–6 yr who underwent general anaesthesia for elective surgery.

Methods

Children who were scheduled to receive general anaesthesia for surgery were recruited for assessment of cognitive function at three times: preoperatively, 1–2 weeks postoperatively, and 3 months postoperatively. Assessments included processing speed, working memory, and fine motor skills. To assess longitudinal changes in the cognitive outcomes, linear mixed models were built with visit number included as a categorical variable and subject-specific random intercepts.

Results

Sixty-one children (33 girls [54%]) enrolled in the study. Twenty-three children (38%) had received general anaesthesia previously. Significant improvements in picture memory, cancellation, and the processing speed composite were found at Visit 2. The improvement in cancellation and processing speed composite remained significant at Visit 3. Statistically significant improvement in Mullen fine motor score was noticed at Visit 3 compared with Visit 1. The pattern of results did not depend upon prior anaesthesia exposure.

Conclusions

General anaesthesia for elective surgery in young children was not associated with declines in working memory, processing speed, and fine motor skills in the first 3 months postoperatively, including in children with prior exposure to anaesthesia.

中文翻译：

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全身麻醉幼儿认知功能的纵向评估

背景

儿童全身麻醉可能与某些认知领域的缺陷有关。目前尚不清楚这些缺陷是否可以在幼儿术后即刻进行测量。本研究的目的是评估接受全身麻醉择期手术的 2.5-6 岁儿童在处理速度、工作记忆和精细运动技能领域的认知功能轨迹。

方法

计划在手术中接受全身麻醉的儿童被招募进行 3 次认知功能评估：术前、术后 1-2 周和术后 3 个月。评估包括处理速度、工作记忆和精细运动技能。为了评估认知结果的纵向变化，建立了线性混合模型，其中访问次数作为分类变量和特定于受试者的随机截距。

结果

61 名儿童（33 名女孩 [54%]）参加了这项研究。23 名儿童 (38%) 之前接受过全身麻醉。在访问 2 中发现图片记忆、消除和综合处理速度的显着改善。在访问 3 中，消除和综合处理速度的改善仍然显着。在访问 3 与访问 1 相比，在统计上观察到 Mullen 精细运动评分的显着改善. 结果的模式不依赖于先前的麻醉暴露。

结论

幼儿择期手术的全身麻醉与术后前 3 个月的工作记忆、处理速度和精细运动技能的下降无关，包括先前接受过麻醉的儿童。