POSTOPERATIVE COGNITIVE IMPAIRMENT IN CHILDREN: THE IMPACT OF SURGICAL PROCEDURE DURATION
Keywords:
postoperative cognitive dysfunction, children, general anesthesia, cognitive impairment, neuropsychological testing, perioperative management, neuroprotectionAbstract
This article presents the results of a comparative study of cognitive impairment in children depending on the duration of elective surgical procedures performed under general anesthesia. The study included 120 children aged 7–14 years, divided into three groups according to the duration of surgery: up to 1 hour (Group I), 1–2 hours (Group II), and more than 2 hours (Group III). Cognitive status was assessed before surgery and on the 7th postoperative day using a battery of neuropsychological tests evaluating memory, attention, psychomotor reaction speed, and executive functions. A statistically significant inverse correlation was found between the duration of surgery and cognitive functioning indicators (r = 0.58–0.69; p < 0.001). The incidence of postoperative cognitive dysfunction (POCD) was 12.5%, 30.0%, and 52.5% in Groups I, II, and III, respectively (χ² = 15.87; p < 0.001). According to logistic regression analysis, a surgical duration exceeding 2 hours was identified as an independent predictor of POCD development (OR = 3.84; 95% CI 1.76–8.42). The obtained findings indicate the need to improve perioperative management protocols for children, taking into account neuroprotective strategies.
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