| Research background and purpose:A large number of animal experiments have confirmed that almost all general anesthesia drugs are associated with abnormal development of immature central nervous system[1-4].But the results of animal experiments cannot be directly translated to humans.Nevertheless,there are few clinical studies and the existing conclusions cannot finally explain the effects of anesthesia on human immature nervous system,especially the long-term effects after exposure to anesthesia.More in-depth clinical studies are needed to explore.In this study,a two-channel transcranial Doppler instrument was used to perform functional transcranial Doppler tests on children after inguinal hernia repair at different periods,and combined with the cognitive assessment form,the effects of two types of anesthesia on postoperative long-term neurocognitive function of infants were explored.Materials and Methods:A total of 159 children who received inguinal hernia repair surgery in the Second People’s Hospital of Yibin from January 1,2017 to December 31,2018,aged from 6months to 3 years at the time of surgery were screened.The anesthesia method including ropivacaine sacral canal anesthesia combined with sevoflurane sedation as a balanced anesthesia preserving spontaneous respiration（Group B,n=77）and general anesthesia（Group G,n=82）.A total of 100 children who were scheduled to receive inguinal hernia repair surgery in the Second People’s Hospital of Yibin from March 1,2022 to September31,2022,aged 3-7 years in hospital,without any previous history of exposure to anesthesia,were screened.Exclusion criteria included any conditions in birth,feeding,growth,or family history that might affect the normal development of the nervous system.Baseline data of all enrolled children were assessed,including left or right handers,height,weight,current learning status,gestational age,birth weight,parental education level,age and time since exposure to anesthesia in group B and group G,etc.The cognitive function of the three groups were measured and compared using functional transcranial Doppler（f TCD）and cognitive assessment scale.Result:1.Duration of anesthesia exposure and incidence of postoperative delirium or agitation in group B were significantly lower than those in group G;There were significant differences in perioperative blood pressure fluctuation between group B and group G（P<0.05）.2.All the blood flow parameters of infants with different anesthesia exposure were normal in the resting period,including Vs,Vd,Vm and PI.There were no significant differences in Vs,Vd and PI among all groups（P>0.05）,and Vm in group B was lower than that in group G and group C（P<0.05）.3.The blood flow trend of the three groups was normal in the visual task and memory task,but there was no obvious blood flow lateralization in the verbal task.There was no significant difference in the CBFV corresponding to the cognitive task among the three groups（P>0.05）.4.All three groups had good to average levels of observation,memory,and communication skills.The memory level of group C was significantly higher than that of groups B and G（P<0.05）.There was no significant difference in memory level between group B and group C（P>0.05）.Conclusion:Exposure to anesthesia during inguinal hernia repair in infants,including sevoflurane balanced anesthesia and tracheal intubation and aspiration combined with general anesthesia,results in postoperative long-term memory decline but does not cause significant abnormalities in cerebral blood flow. |
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