Effects Of Sevolfurane Pre-inhalation On Serum NSE And S100β Protein In Elderly Patients Undergoing Laparoscopic Surgery

Objective：To observe the effects of sevoflurane pre-inhalation on cerebral oxygen andenergy metabolism and serum neuron specific enolase(NSE) and S100β protein inelderly patients undergoing laparoscopic surgery.Methods:Sixty elderly patients， aged65years or above, of ASA Ⅰ or Ⅱ gradescheduled for elective laparoscopic gastrointestinal surgery were divided into threegroups with20cases each:1%sevoflurane group(group S1),2%sevofluranegroup(group S2), control group(group C).1%sevoflurane administered group S1and2%sevoflurane administered group S2for30min after tracheal intubation. After thepneumoperitoneum (intra-abdominal pressure=14mmHg) was established,anaesthesia was maintained without any inhaled anesthetics. Blood samples weretaken from internal jugular vein simultaneously before pneumoperitoneum (T1), at1hafter pneumoperitoneum was established (T2), pneumoperitoneum was terminatedimmediately(T3), at1h after pneumoperitoneum was terminated(T4) for blood gasanalysis and determination of plasma lactic acid concentration. The density of serumNSE and S-100β protein was detected by enzyme-linked immunosorbent assay.Results：Compared with the baseline values at T1, SjvO2increased significantly andDa-jvO2decreased significantly（P<0.05）,but Da-jvGlu and Jlac were not changedsignificantly（P>0.05）at T2～T3in three groups. In three groups, SjvO2、Da-jvO2、Da-jvGlu及Jlac were not changed significantly（P>0.05）at T4compared with that atT（1P>0.05）. Compared with the baseline values at T1, the density of serum NSE andS-100β protein increased significantly at T2～T4in three groups（P<0.05）. In threegroups, the density of serum NSE and S-100β protein increased significantly at T3compared with that at T2（P<0.05）, and increased significantly at T3compared withthat at T（4P<0.05）. The density of serum NSE increased significantly at T4comparedwith that at T2（P<0.05）. SjvO2, Da-jvO2, Da-jvGlu, Jlac,the density of serum NSE and S-100β protein was not significantly changed among the three groups (P>0.05).Conclusion:14mmHg CO2pneumoperitoneum can cause cerebral oxygen supply exceededoxygen consumption, but without impacting on the brain glucose metabolism in theaged.This pneumoperitoneumf can cause certain brain damage in elderly patientsundergoing laparoscopic surgery and it’s need to be researched if the brain damagebelongs to physical changes;1%or2%sevoflurane pre-inhalation has no effect onthe brain damage.