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 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.