Comparison of the Effects of Epidural
Anesthesia and Local Anesthesia in Lumbar
Transforaminal Endoscopic Surgery

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a standard technique for the treatment of lumbar disc hernia. Thus far, most surgeons have recommended local anesthesia. However, in clinical practice, some patients experience pain and are unable to cooperate with the surgery during intervertebral foramen hemp expansion. The use of general anesthesia may create a greater risk of complications because of nerve root anomalies; thus, intraoperative neurophysiological monitoring should be utilized. Reports regarding the use of epidural anesthesia are few in comparison. Objective: To investigate the risks and contingency plans of epidural anesthesia in lumbar transforaminal endoscopic surgery. Study Design: A retrospective analysis of all lumbar transforaminal endoscopic surgeries performed from 2010 to 2014. Setting: Kanghua hospital. Methods: Patients treated with local and epidural anesthesia were divided into 2 groups. In local anesthesia group (A) and local anesthesia group (B), 0.5% lidocaine and 0.25% ropivacaine was administered, respectively. The incidences of complications, including urological complications, in each surgical group as well as Oswestry disability idex (ODI) improvement rates, postoperative patient satisfaction rates, and x-ray exposure times were assessed. Results: From 2010 to 2014, there were 286 cases of lumbar transforaminal endoscopic surgeries, 121 cases utilizing local anesthesia and 165 cases utilizing epidural anesthesia. In cases in which neurological complications occurred after surgery, 15 cases involved nerve root numbness, including one case of foot drop and 2 cases of cerebrospinal leakage in the local anesthesia group, which accounted for 12.4% of group A. However, in the epidural anesthesia group, which accounted for 9.70% of group B, there were 16 cases of nerve root numbness, including 2 cases of foot drop and 2 cases of cerebrospinal leakage. No significant difference was detected in the incidence of neurological complications between the 2 groups (P > 0.05). The ODI improvement rates were 86.0% in the local anesthesia group and 85.4% in the epidural anesthesia group (P > 0.05). The average x-ray exposure times were 14.7 seconds and 16 seconds in the local anesthesia group and epidural anesthesia group, respectively (P > 0.05). The postoperative patient satisfaction rates were 73.6% and 91% in the local anesthesia group and epidural anesthesia group, respectively (P < 0.001). Limitations: This was a single-blind study, and the complications observed were related to the learning curve; all these factors may lead to biases. Conclusions: Epidural anesthesia in transforaminal lumbar surgery is feasible and safe, and no significant difference in neurological complications was observed between the epidural anesthesia and the local anesthesia groups. However, for the patients concerned, the postoperative patient satisfaction rate was significantly greater in the epidural anesthesia group. It is noteworthy that the x-ray exposure times of the groups were not significantly different. Key words: Epidural anesthesia, transforaminal lumbar surgery, neurological complications, cerebrospinal leak

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Effect Analysis of Epidural Anesthesia with 0.4% Ropivacaine in Transforaminal Endoscopic Surgery

Journal of Healthcare Engineering ◽

10.1155/2021/2929843 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Bingwei Hu ◽

Hongwei Wang ◽

Tingting Ma ◽

Zhimei Fu ◽

Zhiying Feng

Keyword(s):

Local Anesthesia ◽

Epidural Anesthesia ◽

Statistical Significance ◽

Pairwise Comparison ◽

Intravenous Anesthesia ◽

Rescue Analgesia ◽

Anesthesia Group ◽

Significant Difference ◽

The Difference ◽

Peak Value

Background. Epidural anesthesia used in percutaneous endoscopic lumber discectomy (PELD) has the risk of complete neurotactile block. Patients cannot timely respond to the operator when the nerve is touched by mistake, so the potential risk of nerve injury cannot be avoided. According to pharmacodynamics, with the decrease of local anesthetic concentration, the nerve tactile gradually recovered; however, the analgesic effect also gradually weakened. Therefore, it is necessary to explore an appropriate concentration of local anesthetics that can keep the patients’ nerve touch without pain. By comparing the advantages and disadvantages of 0.4% ropivacaine epidural anesthesia, local anesthesia and intravenous anesthesia on intraoperative circulation fluctuation, the incidence of salvage analgesia and the incidence of nerve non-touch, the feasibility of using low concentration epidural anesthesia in PELD to obtain enough analgesia and avoid the risk of nerve injury was confirmed. Methods. 153 cases of intervertebral foramen surgery from October 2017 to January 2020 were selected and divided into local anesthesia group (LA group), 0.4% ropivacaine epidural anesthesia group (EA group), and intravenous anesthesia group (IVA group) according to different anesthesia methods. The changes of blood pressure and heart rate, the incidence of rescue analgesia and nerve root non-touch were compared among the three groups. Results. The difference of map peak value among the three groups was statistically significant ( P < 0.001 ); pairwise comparison showed that the map peak value of the LA group was higher than that of the EA group ( P < 0.001 ) and IVA group ( P < 0.001 ), but there was no statistical significance between the EA group and IVA group. The difference of HR peak value among the three groups was statistically significant; pairwise comparison showed that the HR peak value of the LA group was higher than that of the EA group ( P < 0.001 ) and IVA group ( P < 0.001 ), but there was no statistical significance between the EA group and IVA group. There was significant difference in the incidence of intraoperative hypertension among the three groups ( P < 0.05 ); pairwise comparison showed that the incidence of intraoperative hypertension in the EA group was lower than that in the LA group ( P < 0.05 ), while there was no significant difference between the IVA group, EA group, and LA group. There was significant difference in the incidence of rescue analgesia among the three groups ( P < 0.01 ); pairwise comparison showed that the incidence of rescue analgesia in the EA group was lower than that in the LA group ( P < 0.05 ) and IVA group ( P < 0.05 ), but there was no significant difference between the LA group and IVA group. Due to the different analgesic mechanisms of the three anesthesia methods, local anesthesia and intravenous anesthesia do not cause the loss of nerve tactile, while the incidence of nerve tactile in 0.4% ropivacaine epidural anesthesia is only 2.4%, which is still satisfactory. Conclusion. Epidural anesthesia with 0.4% ropivacaine is a better anesthesia method for PELD. It not only has a low incidence of non-tactile nerve, but also has perfect analgesia and more stable intraoperative circulation.

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The Effect of Sevoflurane Anesthesia for Dental Procedure on Neurodevelopment in Children: A Prospective, Equivalence, Controlled Trial

10.21203/rs.3.rs-78114/v1 ◽

2020 ◽

Author(s):

Pinping Zhou ◽

Chao Zhang ◽

Guijin Huang ◽

Yuan Hu ◽

Wenzhu Ma ◽

...

Keyword(s):

General Anesthesia ◽

Local Anesthesia ◽

Primary Outcome ◽

Controlled Trial ◽

Age Groups ◽

Outcome Data ◽

Clinical Trial Registry ◽

General Anesthesia Group ◽

Anesthesia Group ◽

Significant Difference

Abstract Background: Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment.Methods: In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin.Results: The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother's education could affect the primary outcome.Conclusions: In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

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Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

10.21203/rs.3.rs-35064/v1 ◽

2020 ◽

Author(s):

qian he ◽

sujuan zhang ◽

jun zhou ◽

xiong xu ◽

qianqian xu ◽

...

Keyword(s):

Patient Satisfaction ◽

Local Anesthesia ◽

Bispectral Index ◽

Conscious Sedation ◽

Vital Signs ◽

Transbronchial Biopsy ◽

Endobronchial Ultrasound ◽

Safety And Efficacy ◽

Significant Difference ◽

Vas Scores

Abstract Background: Sedation combined with local anesthesia during bronchoscopy is widely accepted in America and Europe, and receiving great attention in China. This study aimed to investigate the safety and efficacy of fentanyl combined with midazolam for bispectral index (BIS) titrated conscious sedation during bronchoscopy in the Chinese population. Methods: Data from 436 patients who underwent bronchoscopy under local anesthesia (LA group) or BIS-guided conscious sedation combined with local anesthesia (FM group) were retrospectively analyzed. The analysis included vital signs, adverse events recorded during the procedure, and questionnaire information, such as patient tolerance and satisfaction, operator satisfaction, and the cough score noted after the procedure. Results: A total of 225 patients in the LA group, and 211 in the FM group were enrolled in the study. The blood pressure and oxygen saturation were significantly higher in the LA group than in the FM group during bronchoscopy (P<0.001). The heart rate was significantly faster in the LA group at T3max, T3min and T4 than in the FM group. The incidence of hypoxia and bradycardia was higher in the FM group than in the LA group, whereas incidence of hypertension and tachycardia was lower. Patient satisfaction and tolerance of the procedure were significantly better in the FM group. visual analog scale (VAS) scores for cough and operator satisfaction were better in the FM group than in the LA group. Sub-group analysis (inspection, biopsy and transbronchial biopsy guided by radial endobronchial ultrasound (rEBUS-TBB)) indicated that the vital signs, adverse event(hypoxia) and patient satisfaction of the two groups were similar to the previous results. However, the VAS scores for operators’ satisfaction was no significant difference between the two groups in patients undergoing inspection. Conclusions: The conscious sedation regimen of fentanyl combined with midazolam monitored by BIS during bronchoscopy is safe and effective. Although the incidence of hypoxia and bradycardia was higher, the patient’s tolerance and physician’s satisfaction were significantly improved, especially during lengthy procedures, such as intrabronchial biopsy and transbronchial biopsy guided by radial endobronchial ultrasound. Trial registration: The study was approved by the ethics committee of Changzhou first people's Hospital (2019-020).

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The effect of sevoflurane anesthesia for dental procedure on neurodevelopment in children: a prospective, equivalence, controlled trial

10.21203/rs.3.rs-33454/v1 ◽

2020 ◽

Author(s):

Pinping Zhou ◽

Chao Zhang ◽

Guijin Huang ◽

Yuan Hu ◽

Wenzhu Ma ◽

...

Keyword(s):

General Anesthesia ◽

Local Anesthesia ◽

Primary Outcome ◽

Controlled Trial ◽

Age Groups ◽

Outcome Data ◽

Clinical Trial Registry ◽

General Anesthesia Group ◽

Anesthesia Group ◽

Significant Difference

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition Chinese version was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110–160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Just the mother's education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

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The effect of sevoflurane anesthesia for dental procedure on neurodevelopment in children: a prospective, equivalence, controlled trial

10.21203/rs.3.rs-33454/v2 ◽

2020 ◽

Author(s):

Pinping Zhou ◽

Chao Zhang ◽

Guijin Huang ◽

Yuan Hu ◽

Wenzhu Ma ◽

...

Keyword(s):

General Anesthesia ◽

Local Anesthesia ◽

Primary Outcome ◽

Controlled Trial ◽

Age Groups ◽

Outcome Data ◽

Factors Affecting ◽

General Anesthesia Group ◽

Anesthesia Group ◽

Significant Difference

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition Chinese version was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Just the mother's education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia.

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Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

10.21203/rs.3.rs-31554/v1 ◽

2020 ◽

Author(s):

Qian He ◽

Sujuan Zhang ◽

Jun Zhou ◽

Xiong Xu ◽

Qianqian Xu ◽

...

Keyword(s):

Patient Satisfaction ◽

Local Anesthesia ◽

Bispectral Index ◽

Conscious Sedation ◽

Vital Signs ◽

Transbronchial Biopsy ◽

Endobronchial Ultrasound ◽

Safety And Efficacy ◽

Significant Difference ◽

Vas Scores

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The Effect of Eutectic Mixture of Local Anesthesia Cream (EMLA) on Satisfaction, Pain, and Nausea/Vomiting of Patients Undergoing Gastro-intestinal Endoscopy-A Randomized Clinical Trial Comparing EMLA Cream and Gel, Lidocaine Gel and Spray, and Placebo

Global Journal of Health Science ◽

10.5539/gjhs.v9n1p273 ◽

2016 ◽

Vol 9 (1) ◽

pp. 273

Author(s):

Jafar Nasiri ◽

Amin Ahmadi ◽

Forouzan Ganji

Keyword(s):

Clinical Trial ◽

Patient Satisfaction ◽

Randomized Clinical Trial ◽

Local Anesthesia ◽

Eutectic Mixture ◽

Double Blind ◽

Patient Satisfaction Score ◽

Emla Cream ◽

Significant Difference ◽

Lidocaine Gel

BACKGROUND & OBJECTIVES: Esophagogastroduodenoscopy is a valuable diagnostic method for the treatment of various diseases that has found a wonderful application in recent years. Yet, controlling patients’ pain and nausea is a fundamental factor to increase patient satisfaction, reduce patients’ discomfort, and increase the patient’s cooperation. Therefore, this study aimed to assess the efficacy of Eutectic Mixture of Local Anesthesia (EMLA) cream and gel, as a topical pharyngeal anesthetic on patients’ pharyngeal pain, nausea/vomiting, and satisfaction, in comparison with lidocaine gel and spray and placebo.METHODS: This double-blind randomized clinical trial was conducted to assess patient satisfaction, nausea/vomiting, throat and pharyngeal pain during and after endoscopy by different methods of local anesthesia. Thus, 150 patients were randomly divided into 5 groups of 30 receiving placebo, lidocaine gel, lidocaine spray, EMLA gel and cream 5 to 10 minutes before endoscopy. Then patient satisfaction (measured by GHAA-9 questionnaire), pain or discomfort in the throat, and nausea/vomiting were evaluated half an hour after endoscopy.RESULTS: Patient satisfaction score was not statistically different between the test groups (P>0.05), but the throat pain and discomfort and nausea/vomiting during and after endoscopy was statistically different between groups (P<0.05) and the lowest nausea/vomiting was in the group using EMLA cream.CONCLUSION: Different methods of throat anesthesia had no significant difference on patient satisfaction but EMLA cream and gel caused less nausea/vomiting than lidocaine gel or spray during and after endoscopy.

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Analysis of percutaneous kyphoplasty under different types of anesthesia for the treatment of multiple osteoporotic vertebral fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03778-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Shuai Zhang ◽

Shuang Xu ◽

Jin Yang ◽

Song Wang ◽

Qing Wang

Keyword(s):

General Anesthesia ◽

Local Anesthesia ◽

Vertebral Fractures ◽

Operative Time ◽

Vertebral Height ◽

Percutaneous Kyphoplasty ◽

Vas Score ◽

Anesthesia Group ◽

Osteoporotic Vertebral Fractures ◽

Significant Difference

Abstract Background Surgeons recognize that using percutaneous kyphoplasty (PKP) under local anesthesia to treat osteoporotic vertebral fracture (OVF) prevents interference with the general situation of elderly patients suffering from multiple organ dysfunction. Surgeons can directly assess whether nerve injury occurs while the patient is awake. However, when patients with multiple osteoporotic vertebral fractures (m-OVFs) receive local anesthesia, fluoroscopy time often has to be increased, the operative time has to be extended, or the operation has to be terminated because of discomfort related to body posture. No relevant study has thus far been conducted on the type of anesthesia to administer to patients undergoing PKP for m-OVFs. This study aimed to determine which of the two types of anesthesia is more suitable for PKP for m-OVFs. Methods A retrospective study was conducted involving 159 patients who underwent PKP for m-OVFs from January 2016 to January 2020; 81 patients underwent PKP under general anesthesia (Group G), and 78 patients underwent PKP under local anesthesia (Group L). Clinical and adverse events were compared between the two groups. Results The intraoperative mean arterial pressure, average heart rate, average fluoroscopy times of each vertebral body, and operative time were less in Group G than in Group L. The visual analog scale (VAS) score was significantly lower after than before the operation. The anterior vertebral height (AVH), middle vertebral height (MVH), and kyphotic angle (KA) were significantly improved in both groups postoperatively. The improvement in VAS score, AVH, MVH, and KA in Group G were higher than those in Group L. No significant difference in the incidence of complications was observed between the two groups. Conclusion PKP under either general anesthesia or local anesthesia was reliable. Compared with PKP under local anesthesia, PKP under general anesthesia could more reliably maintain the stability of vital signs, alleviate preoperative pain in patients, and attain a better orthopedic effect. Moreover, the latter does not increase the complications of patients with m-OVFs. However, the high medical expense of PKP under general anesthesia is a factor to consider when choosing the type of anesthesia.

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Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

BioMed Research International ◽

10.1155/2016/5086414 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Liehua Liu ◽

Shiming Cheng ◽

Rui Lu ◽

Qiang Zhou

Keyword(s):

Local Anesthesia ◽

Nerve Root ◽

Percutaneous Vertebroplasty ◽

Visual Analogue Score ◽

Vertebral Compression Fractures ◽

Improved Method ◽

Percutaneous Kyphoplasty ◽

Significant Difference ◽

Root Effects ◽

Infiltration Anesthesia

Aim.This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Method.From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of71.4±8.8years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA). Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects.Results.VAS of CLIA + EPIA and CLIA group was2.5±0.7and4.3±1.0,respectively, and there was significant difference (P=0.001). In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted.Summary.Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

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The effect of sevoflurane anesthesia for dental procedure on neurocognition in children: a prospective, equivalence, controlled trial

BMC Pediatrics ◽

10.1186/s12887-021-02649-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pinping Zhou ◽

Chao Zhang ◽

Guijin Huang ◽

Yuan Hu ◽

Wenzhu Ma ◽

...

Keyword(s):

General Anesthesia ◽

Local Anesthesia ◽

Primary Outcome ◽

Controlled Trial ◽

Neurocognitive Function ◽

Clinical Trial Registry ◽

General Anesthesia Group ◽

Anesthesia Group ◽

Significant Difference ◽

The Mean

Abstract Background Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children’s life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to whether DGA in children has an adverse effect on neurocognition. Methods In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurocognitive function of children at 6 months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. The predefined clinical equivalence margin was 5 (1/3 SD of FSIQ score). If the 95% CI of the difference between the average FSIQ score of the two groups is within − 5 to + 5, then the two groups are equivalent. Results The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110–160). The mean FSIQ score in the general anesthesia group was 103·12 (SD 8.94), and the mean of the local anesthesia group was 103·58 (SD 8.40). There was equivalence in means of FSIQ score between the two groups (local minus general anesthesia 0.46, 95% CI − 2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother’s education could affect the primary outcome. Conclusions In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurocognitive function at 6 months after surgery compared with awake-local anesthesia. Trial registration Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018.

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