Brain Damage, Postoperative, Surgery-Complications
Conditions
Keywords
brain damage, postoperative, Robot-assisted laparoscopic radical prostatectomy (RALRP), GFAP, NSE, S100B
Brief summary
Robotic assisted laparoscopic surgery has become an alternative to open or laparoscopic technique in various surgical fields. Robot assisted laparoscopic surgery is preferred by surgeons and patients due to easy accessibility, lower blood loss and lower transfusion rates. However, robotic assisted laparoscopic surgery can cause significant changes in cardiovascular, respiratory, metabolic and cerebral physiology because it requires a deep trendy position. When long -lasting deep trendelenburg position is applied, the cerebral autoregulation is impaired. In the literature, the presence of cases with brain edema is shown. In recent years, many biomarkers have been used in the evaluation of brain damage. S100 Calcium Binding Protein (S100β), N Ron specific enolase (NSE), Glial Fibrils are among the biomarkers used to show acidic protein (GFAP) brain damage. The S100β is specific and is mainly produced by astrocytes and enters the bloodstream after neuron damage. Glial fibrils is an acidic protein (GFAP), a protein encoded by the GFAP gene in humans, an intermediate filament protein produced in the central nervous system. Neuron specific enolase (NSE) is one of the enzymes that increase brain damage encoded by Enolase 2 (ENO2) gene. Mini Mental State Examination and Montreal Cognitive Assessment will be performed to determine neurological changes developing in patients. The purpose of this study; Robotic assisted laparoscopic surgery is to examine the brain damage that may develop in patients due to deep trendelenburg position in patients with the said biomarkers and to evaluate the anesthesia methods applied in these surgery in line with the study results.
Interventions
DIAGNOSTIC_TESTMini Mental State Examination(MMSE),Montreal Cognitive Assessment ( MoCA),S100B ( protein S100 subunit beta) ,GFAP ( glial fibrillary acidic protein ),NSE ( neuron-specific enolase )
MMSE and MoCA will be applied preoperative,postoperative first day and fourth day S100B,GFAP and NSE will be measured in blood tests preoperative,postoperative second hour,postoperative 24. hour and postoperative 96. hour
Sponsors
Akdeniz University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* All patients aged 18-75 who were operated on under general anesthesia for RALRP surgery and agreed to participate in the study will be included.
Exclusion criteria
* Participants who did not accept the study, had active intracranial pathology and history of intracranial pathology will not be included in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Serum S100 Beta (S100β) Concentration | Preoperative baseline and postoperative 1, 24, and 96 hours | Serum S100 beta (S100β) concentration was measured using a commercially available sandwich enzyme-linked immunosorbent assay and reported in ng/L. Change from the preoperative baseline concentration was evaluated at each postoperative measurement time point. A positive change indicates an increase and a negative change indicates a decrease relative to baseline. |
| Change From Baseline in Serum Neuron-Specific Enolase (NSE) Concentration | Preoperative baseline and postoperative 1, 24, and 96 hours | Serum neuron-specific enolase (NSE) concentration was measured using a commercially available sandwich enzyme-linked immunosorbent assay and reported in ng/mL. Change from the preoperative baseline concentration was evaluated at each postoperative measurement time point. A positive change indicates an increase and a negative change indicates a decrease relative to baseline. |
| Change From Baseline in Serum Glial Fibrillary Acidic Protein (GFAP) Concentration | Preoperative baseline and postoperative 1, 24, and 96 hours | Serum glial fibrillary acidic protein (GFAP) concentration was measured using a commercially available sandwich enzyme-linked immunosorbent assay and reported in ng/mL. Change from the preoperative baseline concentration was evaluated at each postoperative measurement time point. A positive change indicates an increase and a negative change indicates a decrease relative to baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Mini-Mental State Examination (MMSE) Total Score | Preoperative baseline and postoperative 6, 24, and 96 hours | Cognitive performance was assessed using the Mini-Mental State Examination (MMSE). The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. Change from the preoperative baseline score was evaluated at each postoperative assessment. A negative change indicates a lower postoperative score relative to baseline. |
| Change From Baseline in Montreal Cognitive Assessment (MoCA) Total Score | Preoperative baseline and postoperative 6, 24, and 96 hours | Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. Change from the preoperative baseline score was evaluated at each postoperative assessment. A negative change indicates a lower postoperative score relative to baseline. |
| Number of Participants With an MMSE Total Score of 24 or Lower | Postoperative 6, 24, and 96 hours | At each postoperative assessment, participants with a Mini-Mental State Examination (MMSE) total score of 24 or lower were categorized as having threshold-based early cognitive performance decline. This threshold was used descriptively and was not intended to establish a formal diagnosis of postoperative neurocognitive disorder. |
| Number of Participants With a MoCA Total Score of 21 or Lower | Postoperative 6, 24, and 96 hours | At each postoperative assessment, participants with a Montreal Cognitive Assessment (MoCA) total score of 21 or lower were categorized as having threshold-based early cognitive performance decline. This threshold was used descriptively and was not intended to establish a formal diagnosis of postoperative neurocognitive disorder. |
Countries
Turkey (Türkiye)
Outcome results
None listed