Response of cortisol and cytokines to lower abdominal surgery a comparative study between general anaesthesia and epidural analgesia

ABSTRACT

Thirty patients were allocated randomly to one of two groups according to the types of anesthesia, group I received general anesthesia and group II received epidural analgesia. Venous blood samples were collected from each patient before induction of anesthesia and 20 minutes after the start of surgery for the determination of serum interleukin-1, interleukin-6, tumor necrosis factor, ceruloplasmin, C-reactive protein and cortisol levels. Lower abdominal surgical maneuvers resulted in increase in the level of the parameters tested, the only exception was cortisol which was refractory to change under epidural. All increases in the epidural group were significantly less than that in general anesthesia group. The results of this study showed that the complete afferent neuronal blockade achieved by regional analgesia for surgery of lower abdomen leads to suppression of the cortisol response to surgery and this many influence the value of cytokines studied