Effect of carbon dioxide pneumoperitoneum on the level of serum S-100β and NSE proteins in female patients undergoing gynecological laparoscopy / 中国医师杂志

ABSTRACT

Objectives To investigate the effect of carbon dioxide pneumoperitoneum on postoperative cognitive dysfunction and the level of serum NSE and S-100β protein in female patients undergoing gynecological laparoscopy. Methods 60 ASA physical status Ⅰ patients were divided two groups, group Ⅰ received no insufflation andconventional abdominal surgery ( n = 30) and group Ⅱ received abdominal insufflation and gynecological laparoscopy ( n =30). MMSE was recorded at several different time points, including one day before operation, 1, 6, 24, 48, 72h after operation, and before discharge. Serum S-100β protein and NSE was measured by ELISA before the beginning of operation ( or carbon dioxide pneumoperitoneum) and 1h after operation (or carbon dioxide pneumoperitoneum). Results MMSE values at 1,6,24,48,72h decreased significantly in group Ⅱ (24. 67 ± 1.47,25.97 ± 1.50,26. 77 ± 1.61,27.07 ± 1.87,27.37 ± 2. 06) after operation, compared with group Ⅰ (27.63 ± 1. 33,27.27 ± 0. 87,28.37 ± 0. 85,28.73 ±0. 78,29. 23 ±0. 86, P <0. 01 ). And the baseline value (29. 17 ±0. 76) of serum S-100β[(0. 114 ±0. 012,0. 086 ±0. 009) μg/L] protein and NSE [( 13. 720 ± 1. 330,12. 093 ±0. 697) μg/L] increased significantly at 1h after operation in group Ⅰ and Ⅱ compared with before operation [(0. 035 ±0. 030,0. 035 ±0.024;5.753±0.889,5.831 ±0.967)μg/L, P <0.01]. Serum S-100 β protein[(0. 114 ±0.012) μg/L] increased significantly at 1h after operation in group Ⅱ, compared with group Ⅰ [(0. 086 ±0. 009) μg/L,P < 0. 05], whereas NSE showed not difference [( 12. 093 ± 0. 697,13. 720 ± 1. 330) μg/L, P > 0. 05].Serum of S-100β protein and MMSE were significantly correlated w group Ⅰ and Ⅱ ( r = 0. 6412,0. 8126, P <0.01). Serum NSE was not correlated with the MMSE score in group Ⅰ ( r =0.4397, P >0.05),whereas NSE and MMSE had significant correlation in group Ⅱ ( r = 0. 7111, P <0. 01 ). Conclusions Carbon dioxide pneumoperitoneum in patients with gynecological surgery might affect postoperative cognitive function, and MMSE score was negatively correlated with serum S-100β and NSE proteins.