Absalom, Anthony

Atmosoerodjo, Sawal

Tigchelaar, Celien

Background and Goal: Most knowledge of the neurobiology of the cerebrospinal fluid (CSF) comes from CSF of patients with neurological symptoms or suspected neurodegenerative diseases. We established the Anaesthetic Biobank of Cerebrospinal Fluid (ABC) to facilitate future research using CSF from patients scheduled for elective surgery under spinal anaesthesia. This gives the unique opportunity to study CSF neurobiology in the general population and to help estimate baseline levels of biomarkers of neuropsychiatric diseases. In 2017 we reported the methods and the influence of aspiration of CSF on block height (abstract 06AP02-11). The purpose of the current abstract is to describe the initial technical and laboratory findings.Materials and Methods: All patients ≥18 years scheduled for surgery under spinal anaesthesia are invited to participate. A Montreal Cognitive Assessment (MoCA) and screening neurological examination are performed preoperatively. During IV cannulation 20 ml blood is collected and then 10 ml of CSF is aspirated during spinal puncture prior to local anaesthetic injection. Patient characteristics, medical history, details of surgery and spinal anaesthesia and postoperative hospital stay are recorded and registered. Sensory block height is measured at 10 minutes after spinal injection. 10 ml of blood and the first 2 ml of CSF is sent immediately for routine laboratory analyses. The remaining blood and CSF is centrifuged and stored at -80˚C. Qalb is calculated as the ratio of CSF to plasma albumin concentration, as a quantifier of blood brain barrier (BBB) function. Results: We have enrolled 275 patients (age 18-87 years, BMI 19-45 kg/m2) between October 2016 and November 2018. CSF was obtained in 254 patients (92% of included patients). The median block height was dermatome T8 (IQR T6 – T10). Type of local anaesthetic used had a significant effect on the extent of block (isobaric bupivacaine T6, hyperbaric bupivacaine T8, hyperbaric prilocaine T9; p=0.001). Qalb was significantly correlated with age (p&lt;0.001; r=.420), BMI (p&lt;0.001; r=.242) and MOCA-score (p=0.046; r=-.187) and associated with gender (p&lt;0.001) and ASA-score (p&lt;0.001). Future developments: Our goal is to further expand our research into the fundamental neuro(patho)physiology of CSF and BBB function. In collaboration with our laboratory, analyses of monoamine neurotransmitters and steroids has started. We hope to collaborate with other interested hospitals in the future

The Anaesthetic Biobank of Cerebrospinal Fluid - methods and baseline results

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