Abstract

Objectives To investigate the effect of carbon dioxide pneumoperitoneum on postoperative cognitive dysfunction and the level of serum NSE and S-100β protein in female patients undergoing gynecological laparoscopy. Methods 60 ASA physical status Ⅰ patients were divided two groups, group Ⅰ received no insufflation andconventional abdominal surgery ( n = 30) and group Ⅱ received abdominal insufflation and gynecological laparoscopy ( n =30). MMSE was recorded at several different time points, including one day before operation, 1, 6, 24, 48, 72h after operation, and before discharge. Serum S-100β protein and NSE was measured by ELISA before the beginning of operation ( or carbon dioxide pneumoperitoneum) and 1h after operation (or carbon dioxide pneumoperitoneum). Results MMSE values at 1,6,24,48,72h decreased significantly in group Ⅱ (24. 67 ± 1.47,25.97 ± 1.50,26. 77 ± 1.61,27.07 ± 1.87,27.37 ± 2. 06) after operation, compared with group Ⅰ (27.63 ± 1. 33,27.27 ± 0. 87,28.37 ± 0. 85,28.73 ±0. 78,29. 23 ±0. 86, P 0. 05].Serum of S-100β protein and MMSE were significantly correlated w group Ⅰ and Ⅱ ( r = 0. 6412,0. 8126, P 0.05),whereas NSE and MMSE had significant correlation in group Ⅱ ( r = 0. 7111, P <0. 01 ). Conclusions Carbon dioxide pneumoperitoneum in patients with gynecological surgery might affect postoperative cognitive function, and MMSE score was negatively correlated with serum S-100β and NSE proteins. Key words: Pneumoperitoneum,artificiaL/AE; Carbon dioxide; Laparoscopy; Cognition; S100 proteins/ME; Phosphopyruvate hydratase/ME

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