S100B level and cognitive dysfunction after robotic-assisted laparoscopic radical prostatectomy procedures: a prospective observational study
Nível de S100B e disfunção cognitiva após prostatectomia radical laparoscópica assistida por robô: estudo observacional prospectivo
Nilgun Kavrut Ozturk, Ali Sait Kavakli, Ulku Arslan, Guzin Aykal, Murat Savaş
Abstract
Background
The present study investigated the association between Postoperative Cognitive Dysfunction (POCD) and increased serum S100B level after Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP).
Methods
The study included 82 consecutive patients who underwent RALRP. Serum S100B levels were determined preoperatively, after anesthesia induction, and at 30 minutes and 24 hours postoperatively. Cognitive function was assessed using neuropsychological testing preoperatively and at 7 days and 3 months postoperatively.
Results
Twenty-four patients (29%) exhibited POCD 7 days after surgery, and 9 (11%) at 3 months after surgery. Serum S100B levels were significantly increased at postoperative 30 minutes and 24 hours in patients displaying POCD at postoperative 7 days (p = 0.0001 for both) and 3 months (p = 0.001 for both) compared to patients without POCD. Duration of anesthesia was also significantly longer in patients with POCD at 7 days and 3 months after surgery compared with patients without POCD (p = 0.012, p = 0.001, respectively), as was duration of Trendelenburg (p = 0.025, p = 0.002, respectively). Composite Z score in tests performed on day 7 were significantly correlated with duration of Trendelenburg and duration of anesthesia (p = 0.0001 for both).
Conclusions
S100B increases after RALRP and this increase is associated with POCD development. Duration of Trendelenburg position and anesthesia contribute to the development of POCD.
Trial Registry Number
Clinicaltrials.gov (N° NCT03018522).
Keywords
Resumo
Introdução
O presente estudo investigou a associação entre Disfunção Cognitiva Pós-Operatória (DCPO) e aumento do nível sérico de S100B após Prostatectomia Radical Laparoscópica Assistida por Robô (PRLAR).
Métodos
O estudo incluiu 82 pacientes consecutivos submetidos à PRLAR. Os níveis séricos de S100B foram determinados: no pré-operatório, após indução anestésica, e aos 30 minutos e 24 horas do pós-operatório. A função cognitiva foi avaliada com testes neuropsicológicos no pré-operatório, no 7° Dia Pós-Operatório (7DPO) e aos 3 Meses Após a Cirurgia (3MPO).
Resultados
Observamos 24 pacientes (29%) com DCPO no 7DPO e 9 pacientes com DCPO (11%) após 3 meses da cirurgia. Quando comparados com os pacientes sem DCPO, os níveis séricos de S100B estavam significantemente aumentados aos 30 minutos e às 24 horas do pós-operatório nos pacientes que apresentaram DCPO no 7DPO (p = 0,0001 para os dois momentos) e 3 mês após a cirurgia (p = 0,001 para os dois momentos) A duração anestésica também foi significantemente maior em pacientes com DCPO no 7DPO e 3 pós-operatório em comparação com pacientes sem DCPO (p = 0,012, p = 0,001, respectivamente), assim como a duração da posição de Trendelenburg (p = 0,025, p = 0,002, respectivamente). O escore Z composto nos testes realizados no 7DPO foi significantemente correlacionado com a duração da posição de Trendelenburg e a duração da anestesia (p = 0,0001 para ambos).
Conclusão
S100B aumenta após PRLAR e o aumento está associado ao desenvolvimento de DCPO. A duração anestésica e o tempo decorrido em posição de Trendelenburg contribuem para o desenvolvimento de DCPO.
Número de registro do estudo
Clinicaltrials.gov (n° NCT03018522)
Palavras-chave
References
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