Background and Goal of Study:. Postoperative cognitive dysfunction (POCD) is defined as a new cognitive impairment arising after a surgical procedure and anaesthesia. Its diagnosis requires both pre and postoperative psychometric testing. Its manifestations are subtle and manifold, depending on the particular cognitive domains that are affected. POCD is characterized by mild changes in personality,
emotional instability after anesthesia and surgery,or some loss of cognitive powersc It has been underinvestigated in children. The cause is still unknow, but there are certainly many factors that can affect the occurrence of POCD. The aim of this study was to assess whether the age of children may impact upon the incidence of POCD.
Materials and Methods:Prospective study was conducted at the University Hospital on 64 children (aged 6-13, ASA I-II) undergoing elective adenotonsillectomy. The children were randomized into 2 groups: TIVA and sevoflurane (S). In TIVA group anesthesia was induced with propofol, fentanyl and vecuronium,and maintained with continuous infusion of propofol. In S group after fentanyl, anesthesia was induced and maintained with sevoflurane in O2/N20 (50:50) mixture. BIS monitoring was used and depth of anesthesia accordingly adjusted. Cognitive assessment was conducted with psychomotor evaluation test (PsychE). It is a computer program with two tests: simple reaction time and dual task. Each subject was examined preoperatively, 2 h and 24h after surgery.
Results and Discussion:Table 1 and 2 showed the differences between two age groups of children in simple and dual reaction time results. There were statistical differences (p<0.05) between children younger and older than 9 years in total reaction time and variability of reactions expressed as standard deviations.There weren’t statistical differences (p>0.05) between TIVA and S group in total reaction time in the first postoperative measures but there were statistical differences (p<0.05) between TIVA and S group adjusted for age in standard deviation of total reaction time.
Conclusion(s):It is important to improve the identification and quantification of preoperative risk factors for POCD, as this will assist clinicians and patients in the decision making process (and informed consent) when invasive procedures are planned. Type of anesthesia have impact on variability of reaction but not on
the reaction time and there must be take into account the age of participants.

07 / Postoperative cognitive dysfunction and age of children