Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study

Background The use of sevoflurane, a commonly used paediatric anaesthetic, raises concerns about potential long-term neurotoxic effects on behavioural and neurocognitive development, particularly during critical neurodevelopmental stages in preschool children. Endogenous hydrogen sulfide (H2S), a ne...

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Main Authors: Zhichao Li, Hui Zheng, Shuai Li, Youzhuang Zhu, Xuanyuan Pan, Ruiying Fu, Linhui Ma, Jun Chai
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e098951.full
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author Zhichao Li
Hui Zheng
Shuai Li
Youzhuang Zhu
Xuanyuan Pan
Ruiying Fu
Linhui Ma
Jun Chai
author_facet Zhichao Li
Hui Zheng
Shuai Li
Youzhuang Zhu
Xuanyuan Pan
Ruiying Fu
Linhui Ma
Jun Chai
author_sort Zhichao Li
collection DOAJ
description Background The use of sevoflurane, a commonly used paediatric anaesthetic, raises concerns about potential long-term neurotoxic effects on behavioural and neurocognitive development, particularly during critical neurodevelopmental stages in preschool children. Endogenous hydrogen sulfide (H2S), a neuroprotective gasotransmitter, may be affected by anaesthetic exposure, but its role in sevoflurane-induced neurotoxicity remains unclear.Methods/analysis This prospective cohort study aims to evaluate behavioural and neurocognitive outcomes in 200 preschool children aged 4–6 years (1:1 allocation), with exposure to sevoflurane general anaesthesia (GA) as the primary predictor. A family-centred, professionally guided questionnaire-based assessment approach will be employed. Data accuracy and reliability will be ensured through the integration of real-time medical records and standardised instruments. Moreover, by investigating changes in serum H2S levels among children in the exposed group, this study offers a novel perspective on the potential neurotoxic mechanisms of GA and may inform the development of targeted neuroprotective interventions.Ethics and dissemination Ethical approval was obtained from Shengjing Hospital of China Medical University Ethics Examination Committee (2024PS1204K). We will present the results of the study at national and/or international conferences and in peer-reviewed journals. The study began in October 2024 and is expected to be completed in December 2025.Trial registration number ChiCTR2400090174.
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spelling doaj-art-1ca8fe5d15434dd5bdde679d8bb83aa52025-08-20T02:05:16ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2025-098951Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort studyZhichao Li0Hui Zheng1Shuai Li2Youzhuang Zhu3Xuanyuan Pan4Ruiying Fu5Linhui Ma6Jun Chai7Anaesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, ChinaAnaesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, ChinaAnaesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, ChinaAnaesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaAnaesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaCancer Prevention and Control, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, Beijing, ChinaAnaesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, ChinaAnaesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, ChinaBackground The use of sevoflurane, a commonly used paediatric anaesthetic, raises concerns about potential long-term neurotoxic effects on behavioural and neurocognitive development, particularly during critical neurodevelopmental stages in preschool children. Endogenous hydrogen sulfide (H2S), a neuroprotective gasotransmitter, may be affected by anaesthetic exposure, but its role in sevoflurane-induced neurotoxicity remains unclear.Methods/analysis This prospective cohort study aims to evaluate behavioural and neurocognitive outcomes in 200 preschool children aged 4–6 years (1:1 allocation), with exposure to sevoflurane general anaesthesia (GA) as the primary predictor. A family-centred, professionally guided questionnaire-based assessment approach will be employed. Data accuracy and reliability will be ensured through the integration of real-time medical records and standardised instruments. Moreover, by investigating changes in serum H2S levels among children in the exposed group, this study offers a novel perspective on the potential neurotoxic mechanisms of GA and may inform the development of targeted neuroprotective interventions.Ethics and dissemination Ethical approval was obtained from Shengjing Hospital of China Medical University Ethics Examination Committee (2024PS1204K). We will present the results of the study at national and/or international conferences and in peer-reviewed journals. The study began in October 2024 and is expected to be completed in December 2025.Trial registration number ChiCTR2400090174.https://bmjopen.bmj.com/content/15/6/e098951.full
spellingShingle Zhichao Li
Hui Zheng
Shuai Li
Youzhuang Zhu
Xuanyuan Pan
Ruiying Fu
Linhui Ma
Jun Chai
Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
BMJ Open
title Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
title_full Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
title_fullStr Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
title_full_unstemmed Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
title_short Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study
title_sort long term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children protocol for a prospective cohort study
url https://bmjopen.bmj.com/content/15/6/e098951.full
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