**1. Introduction**

Today, the problem of postoperative delirium (POD) in children is rapidly gaining relevance along with the increase in the number of anesthetic treatments in the world. Preparations for general anesthesia are constantly being improved, new, safer types appear, and outdated ones are losing popularity. The properties of all anesthetics currently used in medicine are being continuously studied. However, based on the mechanism of their action, there is no need to wait for complete safety for the brain, since the purpose of any anesthetic is to influence the functional activity of brain neurons. For children, this effect on the brain is especially dangerous. This is due to the fact that, at the age of up to 1 year, there is active development and change in the structure of the child's brain. First, an excess part of neuroblasts undergo apoptosis, and the rest of them must form dendrites and axons of neurons. Secondly, there is a process of neuronal differentiation and synaptogenesis, which underlies the cognitive development of the child. The effect of anesthetics can disrupt the fine mechanisms of regulation of the described processes and lead to impairments in the cognitive sphere in the immediate or late postoperative period [1–3]. In children, the clinical manifestation of such disorders is primarily postoperative cognitive dysfunction (POCD) and POD. POCD occurs noticeably more often—up to 80% (and even up to 100% in patients with ketamine anesthesia) [4] compared to POD, which occurs in 27–50% of patients [5, 6]. However, identifying POCD is a laborious process. Based on the classic definition given by L.S. Rasmussen et al. back in 2001, this is a cognitive disorder that develops in the early and persists in the late postoperative periods, clinically manifested in the form of impaired memory and other higher cortical functions (thinking, speech, etc.), confirmed by neuropsychological testing data in the form of a decrease in indicators testing in the postoperative period by at least 10% of the preoperative level [7]. In the realities of surgical practice, preoperative

neuropsychological testing of children, despite the battery of tests available for almost all age groups, is extremely rare. This fact sharply reduces the frequency of detection of POCD in pediatric patients.
