Abstract
S100B protein and neuron-specific enolase (NSE) can be considered the markers of cerebral injury. To our knowledge the association of general anesthesia for elective non-cardiac surgery in children with these markers has not been studied before. The goal of this study was to find out whether these markers change after adenotonsillectomy with general anesthesia. The secondary goal was to determine whether different types of anesthesia, gender, age and body mass index are associated with the change of S100B and NSE after adenotonsillectomy with general anesthesia. This study was designed as a prospective clinical trial. We did a simple pre–post experiment with no control group. In 59 children (aged 6–13, ASA I–II) undergoing adenotonsillectomy and randomized to TIVA or inhalational general anesthesia, plasma S100B and NSE were measured during anesthesia before and after the surgery which lasted a median (interquartile range) of 16.5 (13.0–20.0) min. S100B and NSE assays were performed using the electrochemiluminescence immunoassay. Significance of the differences was assessed by two-tailed asymptotic Wilcoxon signed rank test. Main outcome measures were differences in the levels of S100B and NSE before and after the general anesthesia and surgery. There were significant increases in S100B and NSE levels after the surgery. S100B was increased by 38% (P < 0.001) and NSE was increased by 10% (P < 0.001). Increase of S100B was significantly negatively associated with age (P = 0.023). We have not found significant association of S100B and NSE with any other of the monitored variables. The values of neurological biomarkers S100B and NSE were significantly increased after general anesthesia for elective adenotonsillectomy in children.
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References
Cata JP, Abdelmalak B, Farag E (2011) Neurological biomarkers in the perioperative period. Br J Anaesth 107:844–858
Yardan T, Erenler AK, Baydin A, Aydin K, Cokluk C (2011) Usefulness of S100B protein in neurological disorders. J Pak Med Assoc 61:276–281
Streitburger DP, Arelin K, Kratzsch J et al (2011) Validating serum S100B and neuron-specific enolase as biomarkers for the human brain—a combined serum, gene expression and MRI study. PLoS One 7:e43284
Yilmaz FM, Yilmaz H, Tutkun E et al (2014) Serum biochemical markers of central nerve system damage in children with acute elemental mercury intoxication. Clin Toxicol (Phila) 52:32–38
Snyder-Ramos SA, Bottiger BW (2003) Molecular markers of brain damage-clinical and ethical implications with particular focus on cardiac arrest. Restor Neurol Neurosci 21:123–139
Sedaghat F, Notopoulos A (2008) S100 protein family and its application in clinical practice. Hippokratia 12:198–204
Calik M, Abuhandan M, Sonmezler A et al (2013) Elevated serum S-100B levels in children with temporal lobe epilepsy. Seizure 22:99–102
Massaro AN, Chang T, Baumgart S, McCarter R, Nelson KB, Glass P (2014) Biomarkers S100B and neuron-specific enolase predict outcome in hypothermia-treated encephalopathic newborns. Pediatr Crit Care Med 15:615–622
Azapagasi E, Alehan F, Saygi S, Bayraktar N, Yazici AC (2012) Serum concentrations of neuron-specific enolase in pediatric migraine. Turk J Pediatr 54:150–155
Georgiadis D, Berger A, Kowatschev E et al (2000) Predictive value of S-100beta and neuron-specific enolase serum levels for adverse neurologic outcome after cardiac surgery. J Thorac Cardiovasc Surg 119:138–147
Einav S, Kaufman N, Algur N, Kark JD (2012) Modeling serum biomarkers S100 beta and neuron-specific enolase as predictors of outcome after out-of-hospital cardiac arrest: an aid to clinical decision making. J Am Coll Cardiol 60:304–311
Wijeyaratne SM, Collins MA, Barth JH, Gough MJ (2009) Jugular venous neurone specific enolase (NSE) increases following carotid endarterectomy under general, but not local, anaesthesia. Eur J Vasc Endovasc Surg 38:262–266
Andrasevic AT, Baudoin T, Vukelic D et al (2009) ISKRA guidelines on sore throat: diagnostic and therapeutic approach–Croatian national guidelines. Lijec Vjesn 131:181–191
Yuan SM (2014) Biomarkers of cerebral injury in cardiac surgery. Anadolu Kardiyol Derg 14:638–645
Anderson RE, Winnerkvist A, Hansson LO et al (2003) Biochemical markers of cerebrospinal ischemia after repair of aneurysms of the descending and thoracoabdominal aorta. J Cardiothorac Vasc Anesth 17:598–603
Saranteas T, Tachmintzis A, Katsikeris N et al (2007) Perioperative thyroid hormone kinetics in patients undergoing major oral and maxillofacial operations. J Oral Maxillofac Surg 65:408–414
Gazzolo D, Florio P, Zullino E et al (2010) S100B protein increases in human blood and urine during stressful activity. Clin Chem Lab Med 48:1363–1365
Hasselblatt M, Mooren FC, von Ahsen N et al (2004) Serum S100beta increases in marathon runners reflect extracranial release rather than glial damage. Neurology 62:1634–1636
Kalimeris K, Kouni S, Kostopanagiotou G et al (2013) Cognitive function and oxidative stress after carotid endarterectomy: comparison of propofol to sevoflurane anesthesia. J Cardiothorac Vasc Anesth 27:1246–1252
Kanbak M, Saricaoglu F, Akinci SB et al (2007) The effects of isoflurane, sevoflurane, and desflurane anesthesia on neurocognitive outcome after cardiac surgery: a pilot study. Heart Surg Forum 10:E36–E41
Falcone T, Janigro D, Lovell R, Simon B, Brown CA, Herrera M et al (2015) S100B blood levels and childhood trauma in adolescent inpatients. J Psychiatr Res 62:14–22
Grubb NR, Simpson C, Sherwood RA et al (2007) Prediction of cognitive dysfunction after resuscitation from out-of-hospital cardiac arrest using serum neuron-specific enolase and protein S-100. Heart 93:1268–1273
Gazzolo D, Michetti F, Bruschettini M et al (2003) Pediatric concentrations of S100B protein in blood: age- and sex-related changes. Clin Chem 49:967–970
Steiner J, Schiltz K, Walter M et al (2010) S100B serum levels are closely correlated with body mass index: an important caveat in neuropsychiatric research. Psychoneuroendocrinology 35:321–324
Stipic SS, Carev M, Kardum G, Roje Z, Litre DM, Elezovic N (2015) Are postoperative behavioural changes after adenotonsillectomy in children influenced by the type of anaesthesia?: a prospective, randomised clinical study. Eur J Anaesthesiol 32:311–319
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The authors are very grateful to Ms. Irma Krasnic for the English language correction of the manuscript. Statistical data analysis was carried out by Biometrika Healthcare Research, Croatia.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Research Ethics Committee of the University Hospital Split, Croatia (document number: 2181-147-01/M.J-12-2) on 14 June 2012.
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One or both parents of all children were introduced to the main aspects of the research study and they provided a written informed consent.
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Stojanovic Stipic, S., Carev, M., Bajic, Z. et al. Increase of plasma S100B and neuron-specific enolase in children following adenotonsillectomy: a prospective clinical trial. Eur Arch Otorhinolaryngol 274, 3781–3788 (2017). https://doi.org/10.1007/s00405-017-4698-1
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DOI: https://doi.org/10.1007/s00405-017-4698-1