Pre-school children single inhalation anesthetic exposure and neuro-psychological development: a prospective study and Mendelian randomization analysis

作者全名：Zhang, Jinghong; Deng, Haixia; Huang, Xilu; Wang, Lan; Zhou, Pinping; Zeng, Jie; Yu, Cong

作者地址：[Zhang, Jinghong; Deng, Haixia; Huang, Xilu; Wang, Lan; Zeng, Jie; Yu, Cong] Chongqing Med Univ, Dept Anesthesiol, Stomatol Hosp, Chongqing, Peoples R China; [Zhang, Jinghong; Deng, Haixia; Huang, Xilu; Wang, Lan; Zeng, Jie; Yu, Cong] Chongqing Key Lab Oral Dis, Chongqing, Peoples R China; [Zhang, Jinghong; Deng, Haixia; Huang, Xilu; Wang, Lan; Zeng, Jie; Yu, Cong] Chongqing Municipal Key Lab Oral Biomed Engn Highe, Chongqing, Peoples R China; [Zhou, Pinping] Peoples Hosp Changshou, Changshou, Peoples R China

通信作者：Yu, C (通讯作者)，Chongqing Med Univ, Dept Anesthesiol, Stomatol Hosp, Chongqing, Peoples R China.; Yu, C (通讯作者)，Chongqing Key Lab Oral Dis, Chongqing, Peoples R China.; Yu, C (通讯作者)，Chongqing Municipal Key Lab Oral Biomed Engn Highe, Chongqing, Peoples R China.

来源：FRONTIERS IN NEUROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001254294100001

JCR分区：Q2

影响因子：2.7

年份：2024

卷号：15

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：general anesthesia; children dental procedure; Mendelian randomization analysis; growth and development; sevoflurane; neurocognition

摘要：Background For children who are unable to cooperate due to severe dental anxiety (DA), dental treatment of childhood caries under Dental General Anesthesia (DGA) is a safe and high-quality treatment method. This study aims to evaluate the impact on neurocognitive functions and the growth and development of children 2 years after dental procedure based on previous research, and further establish a causal relationship between general anesthesia (GA) and changes in children's neurocognitive functions by incorporating Mendelian Randomization (MR) analysis. Methods Data were collected and analyzed from 340 cases of S-ECC procedures of preschool children conducted in 2019. This involved comparing the neurocognitive outcomes 2 years post-operation of preschool children receiving dental procedures under general anesthesia or local anesthesia. Physical development indicators such as height, weight, and body mass index (BMI) of children were also compared at baseline, half a year post-operation, and 2 years post-operation. We performed a Mendelian randomization analysis on the causal relationship between children's cognitive development and general anesthesia, drawing on a large-scale meta-analysis of GWAS for anesthesia, including multiple general anesthesia datasets. Results Outcome data were obtained for 111 children in the general anesthesia group and 121 children in the local anesthesia group. The mean FSIQ score for the general anesthesia group was 106.77 (SD 6.96), while the mean score for the local anesthesia group was 106.36 (SD 5.88). FSIQ scores were equivalent between the two groups. The incidence of malnutrition in children in the general anesthesia group was 27.93% (p < 0.001) before surgery and decreased to 15.32% (p > 0.05) after 2 years, which was not different from the general population. The IVW method suggested that the causal estimate (p = 0.99 > 0.05, OR = 1.04, 95% CI = 5.98 x 10-4-1.82 x 103) was not statistically significant for disease prevalence. This indicates no genetic cause-and-effect relationship between anesthesia and childhood intelligence. Conclusion There were no adverse outcomes in neurocognitive development in 2 years after severe early childhood caries (S-ECC) procedure under total sevoflurane-inhalation in preschool children. The malnutrition condition in children can be improved after S-ECC procedure under general anesthesia. Limited MR evidence does not support a correlation between genetic susceptibility to anesthesia and an increased risk for intelligence in children.

基金机构：Chongqing Medical University 2022 Future Medical Youth Innovation Team Development Support Program [w0147]

基金资助正文：The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Chongqing Medical University 2022 Future Medical Youth Innovation Team Development Support Program (grant: w0147).r The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Chongqing Medical University 2022 Future Medical Youth Innovation Team Development Support Program (grant: w0147).