Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers: a randomized controlled trial

Steven McGuigan, Lisbeth Evered, David A Scott, Brendan Silbert, Henrik Zetterberg, Kaj Blennow, Steven McGuigan, Lisbeth Evered, David A Scott, Brendan Silbert, Henrik Zetterberg, Kaj Blennow

Abstract

General anesthesia and surgery are associated with an increase in neural injury biomarkers. Elevations of these neural injury biomarkers in the perioperative period are associated with postoperative delirium. Xenon has been shown to be protective against a range of neurological insults in animal models. It remains to be seen if xenon anesthesia is neuroprotective in the perioperative setting in humans. Twenty-four participants scheduled for lithotripsy were randomized to receive either xenon or sevoflurane general anesthesia. There was no statistically significant difference in the concentrations of postoperative neural injury biomarkers between the xenon and sevoflurane group. Following the procedure there was a significant increase in the concentration from baseline of all three biomarkers at 1 hour post-induction with a return to baseline at 5 hours. General anesthesia for lithotripsy was associated with a significant increase at 1 hour post-induction in the neural injury biomarkers total tau, neurofilament light and tau phosphorylated at threonine 181, a marker of tau phosphorylation. The protocol was approved by the St. Vincent's Hospital Melbourne Ethics Committee (approval No. HREC/18/SVHM/221) on July 20, 2018 and was registered with the Australia New Zealand Clinical Trials Registry (registration No. ACTRN12618000916246) on May 31, 2018.

Keywords: biomarkers; inflammation; lithotripsy; neurocognitive disorders; neurofilament; neuroprotection; postoperative delirium; tau; xenon.

Conflict of interest statement

None

Figures

Figure 1
Figure 1
CONsolidated Standards Of Reporting Trials (CONSORT) diagram.
Figure 2
Figure 2
Change in biomarkers over time. Note: Log-transformed values for each participant at each time point are represented by unfilled circles, blue indicates xenon participant, and red indicates sevoflurane participant. Filled circles and line represent log - transformed mean value of each anesthetic group, blue indicates xenon participart, and red indicates sevoflurane participart.

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