PURPOSE: To compare the effects of inhalational anesthetics and intravenous anesthetics on the neurological function of patients with moyamoya disease (MMD) after vascular bypass surgery. METHODS: The clinical anesthesia data of patients were retrospectively collected. Patients who underwent bypass grafts with general anesthesia from January 1st, 2019, to December 31st, 2020, in Huashan Hospital affiliated with Fudan University, were selected. The primary endpoint was stroke incidence within seven days after anesthesia, and the secondary endpoints included transient neurological deficits (TNDs) and incidence of postoperative Epilepsy. RESULTS: We compared the data of MMD patients who received inhalational anesthetics (Sevoflurane anesthetics, n = 197, group S) and intravenous anesthetics (Propofol anesthetics, n = 219, group P). The stroke incidence in the two groups (group S vs. group P) was 6.6% vs. 5.9% (OR = 0.893
95% CI, 0.404-1.976
p = 0.780), and the group S vs. group P of TNDs incidence was 32.5% vs. 31.1% (OR = 0.936
95% CI, 0.619-0.1.415, p = 0.753). At discharge, anesthetics didn't affect the neurological endpoint. Intravenous anesthetics provided patients with better hemodynamics compared with inhalational anesthetics during MMD vascular bypass surgery (group S vs. group P, ARV CONCLUSION: Our data indicated that both inhalational and intravenous anesthetics had protective effects on patients who underwent MMD bypass grafts. MMD patients who received inhalational anesthetics and intravenous anesthetics had similar odds of neurological deficits. When comparing long-term clinical data, most patients experience good neurological recovery after receiving inhalation or intravenous anesthesia, when compared p