Range of S-100 beta levels during functional endoscopic sinus surgery with moderately controlled hypotension

作者：Kwon Youngsuk; Jang Ji Su; Hwang Sung Mi; Lee Jae Jun; Lee Jun Ho; Joo Sungmin; Lee In gon; Hong Sung Jun

来源：European Archives of Oto-Rhino-Laryngology, 2017, 274(9): 3527-3532.

DOI：10.1007/s00405-017-4592-x

• S-100 beta
• Functional endoscopic sinus surgery
• Controlled hypotension
• Cerebral ischemia

The aim of this study is to determine the range of S-100 beta levels during functional endoscopic sinus surgery (FESS) when the mean arterial pressure (MAP) was controlled within 60-70 mmHg. After anesthesia induction with propofol and remifentanil, the patient was positioned in the reverse Trendelenburg position and MAP was controlled within 60-70 mmHg during surgery. For the S-100 beta assay, blood was taken from a radial arterial catheter before (baseline) and at 20 (T (20)) and 60 (T (60)) min after setting the reverse Trendelenburg position and controlled hypotension, and at 60 (T (post60)) min after the end of the operation. In total, 34 patients completed the study. Baseline S-100 beta was 0.00837 +/- 0.00785 ng/mL. The levels at T (20) and T (60) were 0.02057 +/- 0.01739 and 0.01987 +/- 0.01145 ng/mL, respectively. The level of T (post60) was 0.05436 +/- 0.02318 ng/mL. The level at T (20) increased significantly versus the baseline level (P < 0.001); there were no significant differences between T (20) and T (60). The level at T (post60) was significantly different versus T (20) and T (60) (P < 0.001). However, all S-100 beta levels were within the normal range. S-100 beta-a sensitive biomarker of cerebral ischemia-was within the normal range during FESS when moderate hypotension (MAP > 60 mmHg) was provided. Thus, moderate hypotension would be seemed to be a safe and effective anesthetic technique for FESS without risk for cerebral ischemia.

• 出版日期2017-9