{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T05:51:40Z","timestamp":1794289900579,"version":"4.9.0"},"reference-count":60,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T00:00:00Z","timestamp":1749340800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271233"],"award-info":[{"award-number":["82271233"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,15]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      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 (H\n                      <jats:sub>2<\/jats:sub>\n                      S), a neuroprotective gasotransmitter, may be affected by anaesthetic exposure, but its role in sevoflurane-induced neurotoxicity remains unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\/analysis<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study aims to evaluate behavioural and neurocognitive outcomes in 200 preschool children aged 4\u20136 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 H\n                      <jats:sub>2<\/jats:sub>\n                      S 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2400090174.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-098951","type":"journal-article","created":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T15:45:18Z","timestamp":1749397518000},"page":"e098951","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term impact of sevoflurane exposure on behavioural and neurocognitive outcomes in preschool children: protocol for a prospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"Zhichao","family":"Li","sequence":"first","affiliation":[{"name":"Anaesthesiology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese 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