| Objective: To explore the relationship between general anesthesia and infant brain development by analyzing the effects of anesthesia drugs,anesthesia time,number of anesthesia,type of surgery,age of the child at the time of surgery,race of the child,gender of the child,etc.on postoperative neurocognitive function Sex.Methods: By consulting the electronic medical record system of the First Affiliated Hospital of Guangxi Medical University,we collected infants and children aged 0 to 3 who underwent general anesthesia for surgical treatment in the First Affiliated Hospital of Guangxi Medical University between 2012 and2015.Infants and toddlers of the same age,race,and sex who were operated on were used as the corresponding control group.The fourth edition of the Webster’s Intelligence Scale for Young Children(WPPSI-IV)was used to assess the total IQ(FSIQ)and different cognitive dimensions of the tested children,and the Gesell Development Scale(GSCH)was used to assess the developmental quotient(DQ value).The total score of the Achenbach Child Behavior Scale(CBCL)assesses behavioral and personality problems.Collect scores of various scales and different dimensions for statistical analysis,comprehensively evaluate the neurocognitive development of the tested children,analyze anesthesia drugs,anesthesia time,number of anesthesia,type of surgery,age of the child at the time of surgery,race of the child,and child The correlation between gender and postoperative neurocognitive development.Results: A total of 447 cases were included in the experimental group and459 cases in the control group.1.The working memory index(WMI)score(97.51±8.35)of the Wechsler Scale in the experimental group was significantly lower than that of the control group(102.03±11.52)(P<0.05).2.There was no significant difference in the DQ value of the Gessel Scale among children of different genders,different ethnicities,and different surgical sites(P>0.05).The DQ value of children who used remifentanil during anesthesia was lower than that of unused children In children(P<0.05),the total score of the CBCL scale of children who used fentanyl during anesthesia was higher than that of children who were not used(P<0.05).3.In the study of the correlation between weight,age,length of stay in hospital,length of operation,length of anesthesia,and recovery time as influencing factors and the scores of various scales and different dimensions,each influencing factor has an effect on the total IQ and work of the Wechsler scale.The reduction of memory index is correlated(P<0.05);the number of hospitalization days is correlated with the reduction of the DQ value of the Geisel scale(P<0.05).4.Relevant influencing factors are divided into different scales and scores of different dimensions:(1)There was no significant difference between the Wechsler scale total IQ and working memory index between the 6-12 months group and the 0-5 month group at the time of surgery(P>0.05),while the DQ value of the Gessel scale increased(P<0.05);Compared with the group of 1-2 years old at the time of surgery,the total IQ of the Wechsler scale was increased(P<0.05),while the working memory index of the Wechsler scale and the Gessel scale were higher The difference in DQ value was not statistically significant(P>0.05);the total IQ and working memory index of the Wechsler scale were increased in the 2～3year old group and the 0～5 month group(P<0.05),and the Gessel scale DQ The value difference was not statistically significant(P>0.05).(2)Compared with the group weighing 5～10 kg at the time of surgery,the total IQ,working memory index and DQ value of the Geisel scale increased in the Wechsler scale(P < 0.05),and the total score of the CBCL scale was different No statistical significance(P>0.05);compared with the group of 10～15kg and the group of <5 kg,the total IQ and working memory index of the Wechsler scale were increased(P<0.05),the DQ value and CBCL amount of the Gessel scale The total score of the table was not statistically different(P>0.05);the total IQ and working memory index of the Wechsler scale were increased in the 10～15 kg group and the 5～10 kg group(P<0.05),the Gessel scale There was no significant difference between the DQ value and the total score of the CBCL scale(P>0.05);the >15 kg group compared with the <5 kg group,the Wechsler scale total IQ,working memory index and Gessel scale DQ value increased(P<0.05),there was no statistically significant difference in the total score of the CBCL scale(P>0.05);the >15 kg group compared with the5-10 kg group,the total IQ and working memory index of the Wechsler scale increased(P<0.05)),the total score of the CBCL scale decreased(P<0.05),and the difference in the DQ value of the Geisel scale was not statistically significant(P>0.05);the >15 kg group compared with the 10-15 kg group,the Wechsler scale total IQ Increased(P<0.05),there was no significant difference in working memory index,DQ value of Geisel scale and total score of CBCL scale(P>0.05).(3)Compared with the 1-5 days group,the total IQ,working memory index and DQ value of the Wechsler scale decreased in the length of hospital stay> 10 days group(P<0.05),and there was no statistical difference in the total score of the CBCL scale.Academic significance(P>0.05);compared with the 5--10 days group,the total IQ,working memory index and DQ value of the Wechsler scale decreased(P<0.05),the CBCL scale The total score difference was not statistically significant(P>0.05).(4)Compared with the single operation group,the total IQ,working memory index of the Wechsler scale and the DQ value of the Geisel scale were reduced(P<0.05),and the total score of the CBCL scale was not statistically different(P>0.05);Comparing the number of operations>2 group with the single group,the total IQ of the Wechsler scale decreased(P<0.05),the total score of the CBCL scale increased,(P<0.05),working memory index and Gese There was no statistically significant difference in the DQ value of the Wechsler scale(P>0.05);the total score of the CBCL scale was increased in the number of operations>2 times group and the 2 times group,(P<0.05),the total IQ,work of the Wechsler scale There was no statistically significant difference between the memory index and the DQ value of the Gessel Scale(P>0.05).(5)Compared with the operation duration>2h group and <1h group,the total IQ,working memory index and DQ value of the Geisel scale decreased in the Wechsler scale(P<0.05),and the total score of the CBCL scale was not significantly different(P>0.05);Compared with the 1～2h group,the total IQ,working memory index and DQ value of the Wechsler scale decreased in the operation duration>2h group(P<0.05),and there was no statistical difference in the total score of the CBCL scale Academic significance(P>0.05).(6)Comparing the duration of anesthesia>2h group with <1h group,the total IQ and working memory index of the Wechsler scale were lower(P<0.05),and the DQ value of the Gessel Scale and the total score of the CBCL scale were not statistically different(P>0.05);Comparing the duration of anesthesia>2h group with the 1～2h group,the total IQ and working memory index of the Wechsler scale decreased(P<0.05),the DQ value of the Gessel scale and the total score of the CBCL scale were different No statistical significance(P>0.05).(7)There was no difference in wake-up time among the groups(P>0.05).Conclusion: There is no obvious correlation between short-term,single-time general anesthesia and neurodysplasia in infants and young children during brain development.Opioids may have an impact on the development of the nervous system;infants and young children who receive multiple and long-term general anesthesia Some neurological adverse events related to learning ability and attention are more likely to occur in the process of intellectual development. |
