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Human plasma biomarker responses to inhalational general anaesthesia without surgery

Deiner, S; Baxter, MG; Mincer, JS; Sano, M; Hall, J; Mohammed, I; O'Bryant, S; ... Eckenhoff, R; + view all (2020) Human plasma biomarker responses to inhalational general anaesthesia without surgery. British Journal of Anaesthesia , 125 (3) pp. 282-290. 10.1016/j.bja.2020.04.085. Green open access

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Abstract

Background: Postoperative neurocognitive disorders may arise in part from adverse effects of general anaesthetics on the CNS, especially in older patients or individuals otherwise vulnerable to neurotoxicity because of systemic disease or the presence of pre-existing neuropathology. Previous studies have documented cytokine and injury biomarker responses to surgical procedures that included general anaesthesia, but it is not clear to what degree anaesthetics contribute to these responses. / Methods: We performed a prospective cohort study of 59 healthy volunteers aged 40–80 yr who did not undergo surgery. Plasma markers of neurological injury and inflammation were measured immediately before and 5 h after induction of general anaesthesia with 1 minimum alveolar concentration of sevoflurane. Biomarkers included interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), C-reactive protein (CRP), and neural injury (tau, neurofilament light [NF-L], and glial fibrillary acidic protein [GFAP]). / Results: Baseline biomarkers were in the normal range, although NF-L and GFAP were elevated as a function of age. At 5 h after induction of anaesthesia, plasma tau, NF-L, and GFAP were significantly decreased relative to baseline. Plasma IL-6 was significantly increased after anaesthesia, but by a biologically insignificant degree (<1 pg ml−1); plasma TNF-α and CRP were unchanged. / Conclusions: Sevoflurane general anaesthesia without surgery, even in older adults, did not provoke an inflammatory state or neuronal injury at a concentration that is detectable by an acute elevation of measured plasma biomarkers in the early hours after exposure. Clinical trial registration: NCT02275026.

Type: Article
Title: Human plasma biomarker responses to inhalational general anaesthesia without surgery
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.bja.2020.04.085
Publisher version: https://doi.org/10.1016/j.bja.2020.04.085
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: biomarkers; cognitive decline; cytokine; general anaesthetic; neurocognitive disorders; neurofilament; peri-operative; tumour necrosis factor alpha
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10102705
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