OBJECTIVE

To study the markers of brain damage, higher mental functions (HMF) and corrective efficacy of Cytoflavin for postoperative cognitive dysfunction (POCD) after laparoscopic cholecystectomy (VLCE) under inhalation anesthesia with sevoflurane.

MATERIAL AND METHODS

We analyzed 2 representative groups of patients (n=60) who underwent VLCE under inhalation anesthesia with sevoflurane. In perioperative period, brain-specific proteins (protein S-100 and neuron-specific enolase (NSE)) were assessed. Neuropsychological testing was carried out for HMF estimation (Montreal Cognitive Dysfunction Scale (MoCA test), frontal assessment battery (FAB)). POCD correction was not performed in the first group (n=30). In the second group (n=30), POCD correction implied infusion of Cytoflavin 20 ml diluted in saline solution 250 ml a day before surgery and throughout 4 postoperative days.

RESULTS

In the 1^st group, an increase in the levels of protein S-100 and NSE and moderate POCD were revealed. We found significant correlation between NSE level and FAB score. Infusion of Cytoflavin was accompanied by lower levels of brain damage markers and better HMF.

CONCLUSION

VLCE under inhalation anesthesia with sevoflurane is accompanied by increase of brain-specific proteins and development of POCD. Correlation analysis revealed a relationship between NSE and HMF largely determined by inhalation anesthesia. Perioperative administration of Cytoflavin prevents POCD and improves the quality of life.