Role of anaesthesia on cytokine responses to major surgery: inhalational versus intravenous

ABSTRACT

The aim of this study was to investigate the effects of inhalational vs intravenous anaesthesia on cytokines and hormones production in response to major surgery. Twenty patients ASA I and II were randomly allocated to receive either halothane-N0[2] [Inhalation group] or propofol-fentanyl [I.V. group]. Blood samples for cytokines include interleukin-1 beta [IL-1 beta], interleukin-2 [IL-2], interleukin-6 [IL-6] and interferon-lamda [IFN-lamda] and for hormones, cortisol and prolactin concentrations were obtained at intervals; before induction, end of surgery and 24 hours postoperatively. No significant changes were observed in interleukins or hormones concentrations between the two groups before induction of anaesthesia IL-1 beta increased by the end of surgery with no difference between both groups. IL-2 decreased significantly in I.V. group by end of surgery as compared with inhalational group. lL-6 increased significantly in inhalational group and still high 24 h. postoperatively. IFN-lamda decreased significantly by end of surgery in both groups. Cortisol level increased significantly in inhalational group more than in I.V. group by the end of surgery and no significant difference 24 h. postoperatively. Prolactin concentration increased but no significant difference between the two groups throughout the study period. We concluded that I.V. anaesthesia with propofol-fentanyl minimise rise of IL-6 and suppresses release of IL-2 and plasma concentration of cortisol as compared with halothaneNO[2] anaesthesia which increase secretion of IL-2, IL-6 and cortisol concentrations