Abstract
Moyamoya disease (MMD) patients often experience cognitive dysfunction following vascular bypass surgery, with anesthesia potentially influencing recovery. This study aims to evaluate the effects of IVA and combined intravenous and inhalational anesthesia (CIA) on cognitive recovery in MMD patients and explore influencing factors. We included 120 MMD patients who underwent vascular bypass surgery from January 1, 2021, to January 31, 2023. Patients were divided into 2 groups based on anesthesia method: intravenous anesthesia group (n = 56) and CIA group (n = 64). Cognitive function was assessed using mini-mental state examination and Montreal cognitive assessment preoperatively and at 1 week, 1 month, and 3 months postoperatively. Multivariable regression analysis was used to identify factors affecting cognitive recovery. The CIA group showed better cognitive recovery at 1 week, 1 month, and 3 months postoperatively, but the differences between groups were not statistically significant (P > .05). Multivariable regression analysis showed that anesthesia method was not an independent factor influencing recovery, while preoperative cognitive status, age, and comorbidities were significant predictors. Combined intravenous and inhalational anesthesia may offer some advantage for cognitive recovery in MMD patients after vascular bypass surgery, though the differences were not statistically significant. Preoperative cognitive status, age, and comorbidities are key factors in recovery. Anesthesia protocols should be personalized to optimize postoperative cognitive function.