Evaluation of Neuronal Damage in Patients Undergoing Robot-assisted Laparoscopic Radical Prostatectomy With Biomarkers
Evaluation of Intraoperative Neuronal Damage in Patients Undergoing Robot-assisted Laparoscopic Radical Prostatectomy With S100beta, GFAP and NSE Biomarkers
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Ilker O Aycan
- Phone Number: +905056702335
- Email: ilkeraycan@gmail.com
Study Contact Backup
- Name: Bora Dinç
- Phone Number: +905323865600
- Email: drboradinc@gmail.com
Study Locations
-
-
-
Antalya, Turkey (Türkiye), 07070
- Akdeniz University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
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.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Group with Sevoflurane
The Sevoflurane used for maintenance of general anesthesia
|
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
|
|
Group with Propofol
The Propofol (IV) used for maintenance of general anesthesia
|
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
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Serum S100 Beta (S100β) Concentration
Time Frame: 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.
|
Preoperative baseline and postoperative 1, 24, and 96 hours
|
|
Change From Baseline in Serum Neuron-Specific Enolase (NSE) Concentration
Time Frame: 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.
|
Preoperative baseline and postoperative 1, 24, and 96 hours
|
|
Change From Baseline in Serum Glial Fibrillary Acidic Protein (GFAP) Concentration
Time Frame: 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.
|
Preoperative baseline and postoperative 1, 24, and 96 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Mini-Mental State Examination (MMSE) Total Score
Time Frame: 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.
|
Preoperative baseline and postoperative 6, 24, and 96 hours
|
|
Change From Baseline in Montreal Cognitive Assessment (MoCA) Total Score
Time Frame: 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.
|
Preoperative baseline and postoperative 6, 24, and 96 hours
|
|
Number of Participants With an MMSE Total Score of 24 or Lower
Time Frame: 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.
|
Postoperative 6, 24, and 96 hours
|
|
Number of Participants With a MoCA Total Score of 21 or Lower
Time Frame: 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.
|
Postoperative 6, 24, and 96 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Schramm P, Treiber AH, Berres M, Pestel G, Engelhard K, Werner C, Closhen D. Time course of cerebrovascular autoregulation during extreme Trendelenburg position for robotic-assisted prostatic surgery. Anaesthesia. 2014 Jan;69(1):58-63. doi: 10.1111/anae.12477. Epub 2013 Nov 20.
- Amoo M, Henry J, O'Halloran PJ, Brennan P, Husien MB, Campbell M, Caird J, Javadpour M, Curley GF. S100B, GFAP, UCH-L1 and NSE as predictors of abnormalities on CT imaging following mild traumatic brain injury: a systematic review and meta-analysis of diagnostic test accuracy. Neurosurg Rev. 2022 Apr;45(2):1171-1193. doi: 10.1007/s10143-021-01678-z. Epub 2021 Oct 28.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Neuronal damage in RALRP
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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