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The effect of anaesthesia and surgery on plasma cytokine production
Author(s) -
Helmy S. A. K.,
Wahby M. A. M.,
ElNawaway M.
Publication year - 1999
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1999.00947.x
Subject(s) - medicine , sufentanil , anesthesia , cytokine , general anaesthesia , propofol , cholecystectomy , venous blood , laparoscopic cholecystectomy , gastroenterology , surgery
The aim of this study was to investigate cytokine production in response to anaesthesia [total intravenous anaesthesia (TIVA) with propofol, sufentanil and atracurium] and surgery (laparoscopic vs. open cholecystectomy). Forty adult patients, ASA I–II, undergoing elective laparoscopic (group 1) or open (group 2) cholecystectomy were studied. Venous blood samples for measurement of interleukin (IL)‐1β, IL‐2, IL‐4, IL‐6, tumour necrosis factor‐α (TNF‐α) and interferon‐γ (IFN‐γ) were taken before the induction of anaesthesia, pre‐incisionaly, at the end of anaesthesia and surgery and 24‐h postoperatively. Pre‐incisionaly, in both groups, IL‐1β, IL‐4, IL‐6, TNF‐α and IFN‐γ did not show a significant change, whereas IL‐2 showed a significant decrease (p < 0.005 in group 1 and p < 0.001 in group 2) compared with pre‐induction levels. By the end of anaesthesia and surgery, IL‐1β, IL‐2, IL‐4, IL‐6 and TNF‐α showed a significant increase in group 2 (p < 0.005 for IL‐1β, IL‐2 and IL‐4, and p < 0.05 for IL‐6 and TNF‐α); while in group 1, only IL‐2 showed a significant increase (p < 0.01) and IFN‐γ showed a significant decrease (p < 0.05) compared with pre‐incisional levels. By 24‐h postoperatively, IL‐1β, IL‐4, IL‐6 and TNF‐α had decreased significantly in group 2 (p < 0.005 for IL‐4 and p < 0.05 for the others); whereas in group 1, IL‐2 and IFN‐γ showed a significant increase (p < 0.005) compared with the end of anaesthesia and surgery level. In conclusion, TIVA with propofol, sufentanil and atracurium does not seem to have a significant effect on IL‐1β, IL‐4, IL‐6, TNF‐α and IFN‐γ release. IL‐2 was the only cytokine to show a significant decrease due to the effect of anaesthesia alone in both groups. The cytokine response to open cholecystectomy stimulated both the pro‐inflammatory (IL‐1β, IL‐6 and TNF‐α) and the anti‐inflammatory (IL‐4) components, while this response was absent in laparoscopic cholecystectomy.