Fesenko U. The perioperative cognitive dysfunctions in children: anaesthesiologic risk factors, methods of prevention

The dissertation consist of the new ways of increasing general anesthesia safeness in pediatric patients: prevention of noninhalation anesthtics' neurotoxicity and anesthesiologic algorithm in children with difficult airways, that founded on experimental and clinical dates. The noninhalation anesthtics' neurotoxicity and cerebroprotective properties of piracetam and magnesium sulfate were investigated experimentally in rats. Piracetam demonstrated protective action from general anrsthetics' neurotoxicity in experiments and protected cognitive functions after general anesthesia in children. Regional anesthesia with «conscious sedation» demonstrated minimal influence on childrens' cognitive state. Regional anesthesia without sedation and conservative therapy did not affect cognitive functions. The correlation of cognitive functions with pain intensity, preoperative anxiety level, components and methods of anaesthesia, serum levels of stress-hormones, age and sex was studied perioperatively in children. The frequency and causes of difficult tracheal intubation in children with maxillofacial diseases were analyzed. The predictive value of predictor tests for difficult tracheal intubation in children were analyzed statistically.