Children's cognitive recovery after day-case general anesthesia: a randomized trial of propofol or isoflurane for dental procedures

Paediatric Anaesthesia
Keith MillarRichard R Welbury

Abstract

Postoperative cognitive dysfunction (POCD) is well established in adults but has been underinvestigated in children. As day-case procedures are increasingly common, it is important to establish whether children suffer significant POCD. Pediatric POCD has been associated with several intravenous and inhalation anesthetics, but isoflurane has not been studied. As evidence indicates superior recovery after propofol, the study compared POCD after propofol or isoflurane anesthesia. To compare the effects of propofol versus isoflurane upon children's POCD. Fifty-eight children aged 5-14 years were randomized to propofol (total intravenous anesthesia) or isoflurane for day-case dental procedures. Reaction time (RT), verbal and visual memory, psychomotor coordination, and attention were assessed preoperatively, prior to discharge and at 24 h. Reaction time and psychomotor control were impaired postoperatively in both groups but recovered at 24 h. Delayed verbal recall was significantly impaired only after propofol. Both groups had significant impairment of visual memory postoperatively and at 24 h, and of recognition memory postoperatively only. Propofol and isoflurane exert similar adverse effects on RT, psychomotor coordination, and ...Continue Reading

References

Apr 26, 1996·Neuroreport·J SanouP Maurette
Nov 7, 1999·Journal of Clinical and Experimental Neuropsychology·J B RichJ Brandt
Jun 25, 2002·The Annals of Thoracic Surgery·Alexander ColliePaul Maruff
Jan 11, 2005·British Journal of Anaesthesia·C D Hanning
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Aug 19, 2007·Acta Anaesthesiologica Scandinavica·M M Ghoneim, R I Block

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Citations

May 31, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Timothy E Miller, Tong J Gan
Aug 27, 2015·Current Opinion in Anaesthesiology·Lars S Rasmussen, Jacob Steinmetz
Mar 18, 2019·European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry·A LyneD Baldwin

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