• Youngsuk Kwon, Ji Su Jang, Sung Mi Hwang, Jae Jun Lee, LeeJun HoJHDepartment of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Scared Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea., Sungmin Joo, In-Gon Lee, and Sung Jun Hong.
• Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University college of Medicine, 77 Sakju-ro, Chuncheon, 24253, South Korea.
• Eur Arch Otorhinolaryngol. 2017 Sep 1; 274 (9): 3527-3532.

AbstractThe aim of this study is to determine the range of S-100β levels during functional endoscopic sinus surgery (FESS) when the mean arterial pressure (MAP) was controlled within 60-70 mmHg. After anesthesia induction with propofol and remifentanil, the patient was positioned in the reverse Trendelenburg position and MAP was controlled within 60-70 mmHg during surgery. For the S-100β assay, blood was taken from a radial arterial catheter before (baseline) and at 20 (T 20) and 60 (T 60) min after setting the reverse Trendelenburg position and controlled hypotension, and at 60 (T post60) min after the end of the operation. In total, 34 patients completed the study. Baseline S-100β was 0.00837 ± 0.00785 ng/mL. The levels at T 20 and T 60 were 0.02057 ± 0.01739 and 0.01987 ± 0.01145 ng/mL, respectively. The level of T post60 was 0.05436 ± 0.02318 ng/mL. The level at T 20 increased significantly versus the baseline level (P < 0.001); there were no significant differences between T 20 and T 60. The level at T post60 was significantly different versus T 20 and T 60 (P < 0.001). However, all S-100β levels were within the normal range. S-100β-a sensitive biomarker of cerebral ischemia-was within the normal range during FESS when moderate hypotension (MAP >60 mmHg) was provided. Thus, moderate hypotension would be seemed to be a safe and effective anesthetic technique for FESS without risk for cerebral ischemia.

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