Increase of plasma S100B and neuron-specific enolase in children following adenotonsillectomy: a prospective clinical trial

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.

Plasma neurological biomarkers as a measure of neurotoxicity in pediatric dental general anesthesia: a prospective observational feasibility study

“…According to the literature, changes in serum Caspase-3 and NfL levels have been reported following GA exposure (Balasubramanian et al 2021 ). Additionally, specific biomarkers have received considerable interest, such as NSE and S100B protein, for predicting post-operative cognitive dysfunction (Silva et al 2016 ; Stojanovic Stipic et al 2017 ). Therefore, changes in serum levels of four plasma biomarkers: Caspase-3, NSE, NfL and S100B protein were assessed in this study as surrogate markers of neurotoxicity in children.…”

“…Within the literature, a high odds ratio for predicting post-operative cognitive dysfunction for specific established markers, such as neuron-specific enolase (NSE) and S100B protein measurements, have been reported (Silva et al 2016 ; Stojanovic Stipic et al 2017 ). Neurofilament light chain (NfL) has also been used to assess mild brain injury following trauma (Shahim et al 2017 ) and anesthetic exposure (Deiner et al 2020 ).…”

Single tests of implantable cardioverter defibrillators can be performed in selected patients at a low risk of neuronal damage

“…A much larger study would be needed to observe significant effects between DFT and non‐DFT groups. General anesthesia may be associated with an increase in NSE, making the comparison between patients operated on in sedation and general anesthesia difficult, which has been done previously 12,15 …”