Ovezov A M, Lobov M A, Panteleeva M V, Lugovoĭ A V, Miatchin P S, Gus'kov I E
Anesteziol Reanimatol. 2012 May-Jun(3):25-9.
The aim of the study was to assess the possibility and effectiveness of hopaten acid use for early postoperative cognitive dysfunction correction in children of school age.
In compliance with inclusion and exclusion criteria, totally 40 children of school age (7-16 years old, ASA status I-II) with surgical pathology: (varicocele, cryptorchidism, inguinal hernia) were included A comperative assessment of neuropsychic status during pre - and postoperative are period in children, operated under propofol-fentanyl total intravenous anesthesia (TIVA) was conducted All patients were randomized to the control (without cepebroprotection 1st group, 20 children) and experimental (using cepebroprotection with hopaten acid within 1 month after the operation, 2nd group, 20 children) groups. Dimension of the study: Harvard standard monitoring, respiratory gas composition, neuropsychic tests (Bourdon test, "10 words test", etc.).
For full compatibility groups (age, ASA status and anthropometric data, equal operation duration and the equipotential drug dosage adjustment is revealed, that in group of propofol-fentanyl TIVA in the early postoperative period in school age children postoperative cognitive dysfunction (POCD) is developing, which in case of absence of the corresponding correction is maintained after 1 month after operation (at least) in 80% of cases. In the application of hopaten acid cerebroprotection (40 mg/kg per day) severity of POCD reliably is reduced or compensated by the time of discharge from the hospital (3-7-th day when non-traumatic interventions), and 1 month after the operation in 30% of patients experienced improvement of cognitive functions, which proves the effectiveness of hopaten acid for POCD treatment.
In case of propofol-fentanyl TIVA anesthesia in children of school age is indicated preventive prescription of multimodal cerebroprotectors without age limitations (for example hopaten acid (40 mg/kg per day) for POCD treatment.
本研究的目的是评估使用霍帕坦酸纠正学龄儿童术后早期认知功能障碍的可能性和有效性。
按照纳入和排除标准，共纳入40名患有外科疾病（精索静脉曲张、隐睾症、腹股沟疝）的学龄儿童（7 - 16岁，ASA分级I - II级）。对在丙泊酚 - 芬太尼全静脉麻醉（TIVA）下手术的儿童术前和术后一段时间内的神经精神状态进行了比较评估。所有患者随机分为对照组（未进行脑保护，第1组，20名儿童）和实验组（术后1个月内使用霍帕坦酸进行脑保护，第2组，20名儿童）。研究范围包括：哈佛标准监测、呼吸气体成分、神经精神测试（布尔东测试、“10词测试”等）。
对于完全匹配的组（年龄、ASA分级和人体测量数据、手术持续时间相等且药物剂量调整等电位），发现在学龄儿童术后早期，丙泊酚 - 芬太尼TIVA组会出现术后认知功能障碍（POCD），如果没有相应的纠正措施，术后1个月（至少）80%的病例中这种情况会持续存在。在应用霍帕坦酸脑保护（每天40mg/kg）后，到出院时（非创伤性干预时为第3 - 7天）POCD的严重程度可靠地降低或得到补偿，术后1个月30%的患者认知功能得到改善，这证明了霍帕坦酸对POCD治疗的有效性。
对于学龄儿童丙泊酚 - 芬太尼TIVA麻醉，建议预防性使用无年龄限制的多模式脑保护剂（例如用于POCD治疗的霍帕坦酸（每天40mg/kg））。
