Prognostic study of sevoflurane-based general anesthesia on cognitive function in children



It is unclear whether volatile general anesthetics have sustained adverse effects on the immature brains of children. We performed a self-controlled study to evaluate the effects of strabismus surgery under sevoflurane-based general anesthesia on the cognitive function of pediatric patients.


The study included 100 children of ages 4 to 7 years old scheduled to undergo strabismus correction under sevoflurane-based general anesthesia. Cognitive function was tested 1 day before the operation (T1), 1 month after the operation (T2), and 6 months after the operation by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) (Third Edition) method, which consists of 150 items. The scores at T1 were compared with scores at T2 and T3.


Seventy-two children completed the three tests. At T1, they were 66.1 ± 7.7 months old and had a mean body weight of 21.6 ± 4.0 kg. The mean anesthesia time was 67.3 ± 9.8 min. The mean interval between T1 and T2 was 25.4 ± 6.8 days, and that between T1 and T3 was 182.1 ± 27.7 days. No statistically significant decrease in WPPSI scores was observed between T1 and T2, or between T1 and T3.


These findings from our self-controlled study show that sevoflurane-based general anesthesia does not have significantly adverse effects on the cognitive function of 4- to 7-year-old children at 1 month and 6 months after strabismus surgery. Additional studies with a larger sample size are needed.

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This study was supported by a Young Scholar Funding from the Shanghai Department of Health and a BRAUN Research Funding of Anesthesiology (year 2010). We are grateful to Yasong Du (M.D.) and Lianghan Jiang (M.S.) (both at the Department of Pediatric Psychology, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine) for their assistance. Professors Xiaomei Qu (M.D.) and Hong Liu (M.D.) at the Eye & ENT Hospital of Fudan University provided assistance for this study.

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Correspondence to Yirong Cai.

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Fan, Q., Cai, Y., Chen, K. et al. Prognostic study of sevoflurane-based general anesthesia on cognitive function in children. J Anesth 27, 493–499 (2013).

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  • Child
  • Wechsler scales
  • Executive function
  • Sevoflurane
  • General anesthesia