Influence of laryngeal mask airway (LMA) insertion anesthesia on cognitive function after microsurgery in pediatric neurosurgery.

OBJECTIVE: To compare the influence of laryngeal mask airway (LMA) insertion anesthesia and endotracheal intubation on cognitive function during anesthesia for neurosurgery microscopy.

PATIENTS AND METHODS: A total of 76 pediatric patients who underwent neurosurgery microscopy were selected. They were randomly divided in the LMA insertion group with 35 cases and the endotracheal intubation group with 41 cases. Before the operation, the two groups were injected with 0.02 mg/kg atropine and 2 mg/kg phenobarbital. A combination solution of 2 mg/kg ketamine and 0.1 mg/kg midazolam was then given to induce anesthesia. The inhalation of 4-6% sevoflurane was used to maintain anesthesia. The hemodynamics, complications, cognitive functions, and expression levels of serum NSE and S-100β protein after anesthesia and extubation were compared.

RESULTS: After comparing the average heart rate, average arterial pressure and average oxygen saturation of the LMA insertion group at different times, the difference was not statistically significant (p>0.05). At T2 and T4, compared with the endotracheal intubation group, the average heart rate and arterial pressure of the LMA insertion group were significantly reduced and the average oxygen saturation was significantly increased. The difference was statistically significant (p<0.05). The prevalence of complications from postoperative cognitive dysfunction (POCD) of the LMA insertion group was significantly lower than that of the endotracheal incubation group. The difference was statistically significant (p<0.05).

CONCLUSIONS: Compared with the endotracheal intubation group, in the LMA insertion group, the hemodynamics is more stable, the prevalence of postoperative complications and the POCD are lower during pediatric neurosurgery microscopy. The occurrence of POCD is related to the reduction of protein expression levels of NSE and S-100β during serum anesthesia and the recovery period.