@article{Enlund_Mentell_Engström_Horneman_Ronquist_1996, title={Occurrence of Adenylate Kinase in Cerebrospinal Fluid after Isoflurane Anaesthesia and Orthognathic Surgery}, volume={101}, url={https://ujms.net/index.php/ujms/article/view/6667}, DOI={10.3109/03009739609178916}, abstractNote={<p>The study objective was, firstly, to investigate whether anaesthesia with induced arterial hypotension would cause leakage of a biochemical marker of neuronal injury, adenylate kinase (AK), into the cerebrospinal fluid (CSF). (Definition: arterial hypotension = mean arterial pressure (MAP) 50–65 mmHg during ≥ 10 rnin). Secondly, a subgroup of patients was examined with a limited battery of psychometric tests.</p> <p>Patients, scheduled for orthognathic surgery, were allocated to either hypotension (n=20) or normotension (n=20). Seventeen patients were subjected to psychometry.</p> <p>Arterial blood pressure was recorded continuously and controlled by adjustments of the administered concentration of the inhalational anaesthetic isoflurane. Fentanyl, an opioid, was given equally in both groups. A lumbar puncture was performed approximately 20 h post-operatively for a CSF sample, later analysed for AK activity. Neuropsychological tests were performed the day before surgery and the fourteenth day postoperatively.</p> <p>The CSF-AK value was pathologically increased (&gt;0.040 U/L) in 24 patients (65%), of whom 9 were normotensive. There was no significant difference between the CSF-AK values in the hypotensive and normotensive groups, mean values were 0.082 (s.d. 0.051) and 0.066 (s.d. 0.059) U/L, respectively. The overall correlation between the 10 rnin MAP levels and the CSF-AK values was close to zero. In the pilot neuropsychological investigation some abnormalities were observed, indicating clinically significant adverse effects in four hypotensive patients, of whom two displayed pathologically increased CSF-AK values. At the group level, the correlation between the changes in psychometry and the measured CSF-AK values was poor.</p> <p>Increases in CSF-AK activities may be a non-specific occurrence in the perioperative interval, possibly indicating an adverse effect on the brain. Arterial hypotension could not be proven to explain the CSF-AK outcome.</p&gt;}, number={1}, journal={Upsala Journal of Medical Sciences}, author={Enlund Mats and Mentell Ove and Engström Christina and Horneman Göran and Ronquist Gunnar}, year={1996}, month={Jul.}, pages={97-112} }