Comparison of the effect of propofol and desflurane on S-100β and GFAP levels during controlled hypotension for functional endoscopic sinus surgery A randomized controlled trial

Background: Although surgical field visualization is important in functional endoscopic sinus surgery (FESS), the complications associated with controlled hypotension for surgery should be considered. Intraoperative hypotension is associated with postoperative stroke, leading to subsequent hypoxia with potential neurologic injury. We investigated the effect of propofol and desflurane anesthesia on S-100 beta and glial fibrillary acidic protein (GFAP) levels which are early biomarkers for cerebral ischemic change during controlled hypotension for FESS. Methods: For controlled hypotension during FESS, anesthesia was maintained with propofol/remifentanil in propofol group (n=30) and with desflurane/remifentanil in desflurane group (n=30). For S-100 beta and GFAP assay, blood samples were taken at base, 20 and 60 minutes after achieving the target range of mean arterial pressure, and at 60 minutes after surgery. Results: The base levels of S-100 beta were 98.04 +/- 78.57 and 112.61 +/- 66.38pg/mL in the propofol and desflurane groups, respectively. The base levels of GFAP were 0.997 +/- 0.486 and 0.898 +/- 0.472ng/mL in the propofol and desflurane groups, respectively. The S-100 beta and GFAP levels were significantly increased in the study period compared to the base levels in both groups (P <=.001). There was no significant difference at each time point between the 2 groups. Conclusion: On comparing the effects of propofol and desflurane anesthesia for controlled hypotension on the levels of S-100 beta and GFAP, we noted that there was no significant difference in S-100 beta and GFAP levels between the 2 study groups.