Effects of different combinations of desflurane,evoflurane and propofol on postoperative cognitive function in school-age children

XIE Yeqing; LIU Huan; WANG Yan; LIU Chengxi; YANG Yan; LIU Wenjie; LI Zhixiu

doi:10.3969/j.issn.2096-2681.2025.06.008

Abstract：Objective To compare the effects of different combinations of desflurane,sevoflurane,and propofol on postoperative cognitive function of school-age children.Methods A total of 150 children,aged 5-12 years old,of American Society of Anesthesiologists(ASA)physical status Ⅰ or Ⅱ,who underwent elective tonsil and/or adenoidectomy,from June 2018 to January 2020,in the Second Affiliated Hospital of University of South China and the First Affiliated Hospital of University of South China,were selected as the subjects.According to different combinations of induction and maintenance drugs,they were randomly divided into five groups:sevoflurane-induced and sevoflurane-maintenance group(SS group),sevoflurane-induced and propofol-maintenance group(SP group),sevoflurane-induced and desflurane-maintenance group(SD group),propofol-induced and propofol-maintenance group(PP group),propofol-induced and desflurane-maintenance group(PD group),with 30 cases in each group,according to random number table method.Peabody picture vocabulary test(PPVT)scores were assessed on the day before surgery(T0)and the day after surgery(T1),and combined Raven's test(CRT)scores were assessed at 3 d,1 month,and 3 months after surgery.Serum concentrations of S100β protein and neuron-specific enolase(NSE)were measured at T0 and T1.Recovery time,extubating time,and PACU stay time were recorded.Results There were no statistically significant differences among the five groups in PPVT scores and serum S100β protein concentrations at T0 and T1(P＞0.05),and no statistically significant differences were observed among the groups(P＞0.05).The CRT scores of the five groups showed no statistically significant differences at 3 d,1 month,and 3 months postoperatively(P＞0.05),and no statistically significant differences were found among the groups(P＞0.05).The NSE concentration of the five groups in serum at T1 was higher than that at T0,and this difference was statistically significant(P＞0.05),while there were no statistically significant differences among the groups(P＞0.05).The SD group and PD group had shorter recovery time and extubation time than other groups,with the SD group having the shortest time,showing statistically significant differences(P＜0.05).Conclusion Different combinations of induction and maintenance agents(desflurane,sevoflurane,and propofol)don't result in cognitive impairment in school-aged children without prior exposure to anesthesia.Additionally,maintenance with desflurane offers the advantages of rapid awakening and early extubation,making it suitable for short pediatric surgeries.