Influence of general anesthesia for tonsillotomy and adenotomy to cognitive functions in children

Abstract

Background. Surgery under general anesthesia can affect the patients neurocognitive outcome. This problem is of particular relevance in pediatric surgical practice.
 Goal. The aim of this study is to determine the spectrum of clinical manifestations and the frequency of cognitive dysfunction symptom development in children after adenotomy and/or tonsillotomy performed under general anesthesia.
 Methods. This prospective study included 30 children aged 3 7 years (average age 4.9 1.3 years) who underwent adenotomy and/or tonsillotomy under general, combined, balanced anesthesia. In the preoperative period and a day after the operation, neuropsychological testing was performed: The Raven test, mechanical and associative memory test, Mini-Mental State Examination (MMSE) scale adapted for children from 3 years old, and the Bourdon test. A 20% decrease in function compared with the initial level was considered clinically significant.
 Results. One day after surgery, 10% of patients had a clinically significant decrease in attention productivity, 10% had a decrease in attention accuracy, 13.3% had a decrease in attention index, and 16.7% had a decrease in overall productivity and the attention index according to the Bourdon test. Also, 13.3% showed a decrease in attention, 30% had a decrease in memory on the MMSE scale, 20% showed a decrease in mechanical memory, and 10% had a decrease in test results on the Raven test.
 Conclusion. Conducting even minor surgical interventions with general anesthesia leads to an impairment of various cognitive functions in 10%30% of children aged 3 to 7 years.