Effects of CO2 Pneumoperitoneum on the Cognitive Function of Patients Undergoing Gynecologic Laparoscopy.
OBJECTIVE
To evaluate the effects of CO2 pneumoperitoneum during gynecologic laparoscopy on patients' postoperative cognitive function.


METHODS
This prospective clinical study included 225 adult female patients with American Society of Anesthesiologists physical status I or II. Patients underwent conventional open surgery (group I, n = 115) or gynecologic laparoscopy using abdominal insufflation with CO2 to an intra-abdominal pressure of 15 mm Hg (group II, n = 110). Serum S100β and neuron-specific enolase (NSE) concentrations were measured, both immediately before surgery and before the patient awoke after surgery. The Mini-Mental State Examination (MMSE) was administered 1 day before surgery as well as 1, 6, 12, 24 and 72 h after surgery and before discharge.


RESULTS
MMSE scores were significantly lower relative to baseline at 1, 6 and 12 h post surgery, but returned to baseline by 48 h (group I) or 72 h (group II) post surgery. One hour after surgery, S100β serum levels were higher in group II than in group I (p < 0.05). NSE levels did not differ between the groups. In group II, the MMSE score significantly correlated with serum S100β or NSE concentrations.


CONCLUSIONS
CO2 pneumoperitoneum influences postoperative cognitive function in patients undergoing gynecologic laparoscopy.
Department of Anesthesiology, First Affiliated Hospital of China Medical University, Shenyang, China.
Lu-Lu
LL
Liu
Ning
N
Bao
Huang-Wei
HW
Lu
D000328:Adult; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*
D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; D010751:Phosphopyruvate Hydratase