Optimised Anaesthesia in Abdominal Cancer Surgery does Not Prevent Increase in Biomarkers of Neuroinflammation

Neurocognitive decline during the perioperative period represents a risk of significant complications, including dementia and even death. Our prospective study included high-risk surgical patients who underwent large intestinal resections. Balanced anaesthesia was used to maximize cerebral protection. The release of NSE, protein S-100, matrix metalloproteinase-9 (MMP-9) and other biomarkers of cerebral injury and inflammation were measured during and after surgery to obtain the perioperative concentration profile and to identify possible clinically useful markers. Profiles of proteins MMP-9 and S-100 showed perioperative increase, which was in accordance with intraoperative cerebral injury. The S-100 and NSE plasma levels remained within normal values. The level of NSE even decreased, probably due to intraoperative fluid infusion. Our study showed that the use of neuroprotective anesthesia can reduce neuroinflammation. The study also highlights the perioperative expression of proteins MMP-9 and S-100, which might be useful as biomarkers of cerebral injury in the context of balanced anesthesia during major abdominal surgery.