The Effect of Pneumoperitoneum Duration on Serum S100B Level Alterations During Laparoscopic Surgery in the Operating Theater of Universitas Airlangga Hospital

Abstract

Background: Laparoscopic surgery is more recommended due to its advantages over conventional surgery, particularly its faster recovery time. However, laparoscopic surgery also has short-term and long-term disadvantages, one of which is the occurrence of Postoperative Cognitive Disorder (POCD). This condition can occur because laparoscopic procedures utilize CO2 gas to facilitate the surgeon visualization of the surgical field. The pneumoperitoneum condition results in increased intra-abdominal pressure (IAP). Elevated IAP can lead to a reduction in cerebral perfusion pressure (CPP), causing cerebral edema. S100B can serve as a biomarker for brain injury, as it originates from astrocytes and glial cells. This study aims to analyze the effect of pneumoperitoneum duration on changes in S100B levels during laparoscopic surgery.
Methods: This study used a cross-sectional analytic observational study, using a time- and number-limited consecutive sampling method. A total of 30 samples were drawn from the study population, which included adult patients with ASA physical status 1-2 undergoing laparoscopic surgery in the digestive or gynecological department at the Operating Theatre of Universitas Airlangga Hospital, Surabaya.Results: The study results demonstrated an increase in postoperative S100B levels. Comparative analysis of preoperative and postoperative S100B levels using the Wilcoxon Signed Rank test yielded a p-value of 0,049 (p < 0,05), indicating a significant difference between pre-laparoscopic and post-laparoscopic surgery S100B levels. Further analysis of the correlation between pneumoperitoneum duration and changes in S100B levels using the Spearman test resulted in a p-value of 0,870 (p > 0,05), indicating no significant correlation between pneumoperitoneum duration and alterations in S100B levels.
Conclusion: There was an increase in S100B levels between preoperative and postoperative periods in laparoscopic surgery; however, the duration of the laparoscopy did not affect changes in S100B levels. Other factors influencing changes in S100B levels include conditions during laparoscopy, such as hypoperfusion and hypoxemia.