A Pilot Study Of The RNA Oxidation Level Changes In Urine Following CABG And Lobectomy

Objective:To evaluate the changes of RNA oxidation level and cognitive function following coronary artery bypass grafting and video-assisted thracoscopic lobectomy.Methods:The prospective study included thirteen cases of coronary artery bypass grafting (CABG) and twenty-one cases of video-assisted thracoscopic lobectomy (VATSL) under general anesthesia performed in Beijing Hospital from Nov.2014 to Jan.2015. Eligible patients were approved of the protocol; had presented for CABG and VATSL; ASA Ⅰ～Ⅲ.There was no restriction on the age and gender. We excluded patients if they had:were unwilling to comply with the protocol; were unable to understand the language used; with any sever visual and auditory disorders, with sever hepatic and renal dysfunction; a disease of the central nervous system; had been admitted for neurological surgery, alcohol addiction and drug addiction. During the observation, there were no regulations on the performance of surgery and anesthesia, and the operators and anesthetists were both blind to the research. Main outcome measures:1. Collect the basic information before operation, such as age, gender, height, weight, and past medical history and ASA level.2. Collect the single urine of the patients during 8:00 to 10:00 a.m. on the day before the surgery and the 1,2,3,5,7 days after surgery, measure the marker of the RNA oxidation level,8-oxoGsn, through ID-LC/MS-MS.3. Evaluate the cognitive function on the day before the surgery and the seventh day after surgery using Mini-Mental State Examination.Results:All patients enrolled in the research completed the survey. The basic information of both surgery were similar, except age and diabetes mellitus history. The RNA oxidation level, marked by 8-oxoGsn, both increased on the 1,2,3,5,7 days after surgery without returning to the basic level before operation, and was significantly increased on the 5 days after surgery, P<0.05. The RNA oxidation level after CABG increased more than VATSL, and was significantly on the 5 days after surgery, P<0.05. The mean of MMSE score on the seven day after operation was lower than the day before operation. At 7 days after the surgery, we found postoperative cognitive dysfunction in two (15.4%) of CABG patients, two (9.5%) of VATSL patients, the incidence of POCD in CABG patients was higher, though without statistical significance.Conclusions:Anesthesia and surgery can cause both increases on RNA oxidation level and cognitive function, and more significantly in CABG than VATSL.