Интраоперационная профилактика когнитивных нарушений при тотальной внутривенной анестезии у детей школьного возраста: рандомизированное клиническое исследование

Александр Валерьевич Луговой; М. В. Пантелеева; Е. Д. Надькина; А. М. Овезов

doi:10.21320/1818-474X-2018-4-57-64

No. 4 (2018), SELECTED ISSUES IN ANESTHESIOLOGY

No. 4 (2018)

SELECTED ISSUES IN ANESTHESIOLOGY

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

Published 25.12.2018

Alexandr V. Lugovoy⁺⁻
M.V. Panteleeva⁺⁻
E.D. Nadkina⁺⁻
A.M. Ovezov⁺⁻

Alexandr V. Lugovoy

Vladimirsky Moscow Regional Clinical Research Institute, Moscow

https://orcid.org/0000-0003-3715-8699

M.V. Panteleeva

Vladimirsky Moscow Regional Clinical Research Institute, Moscow

https://orcid.org/0000-0002-4099-8202

E.D. Nadkina

Vladimirsky Moscow Regional Clinical Research Institute, Moscow

https://orcid.org/0000-0002-2360-1699

A.M. Ovezov

Vladimirsky Moscow Regional Clinical Research Institute, Moscow

https://orcid.org/0000-0001-7629-6280

PDF_2018-4_57-64 (Russian)

Keywords

postoperative cognitive dysfunction
total intravenous anesthesia
propofol
cytoflavine
school-age children

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Lugovoy A.V., Panteleeva M.V., Nadkina E.D., Ovezov A.M. Intraoperative prevention of cognitive impairment in total intravenous anesthesia in school-age children: randomized clinical trial. Annals of Critical Care. 2018;(4):57-64. doi:10.21320/1818-474X-2018-4-57-64

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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 7th day of postoperative period — at 3.33 %. In group 2, on the first day of the postoperative period, POCD was verified in 13.79 % of patients, on the 7th 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.

PDF_2018-4_57-64 (Russian)

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

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

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