Effects of balanced anesthesia with sevoflurane-remifentanil and total intravenous anesthesia with propofol-remifentanil on postoperative stress responses in patients with stomach cancer

ABSTRACT

BACKGROUND: The effects of anesthetics on postoperative stress response remains not fully understood. We evaluated the effects of sevoflurane-remifentanil balanced anesthesia and propofol-remifentanil total intravenous anesthesia (TIVA) on postoperative interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), cortisol, and laboratory test values for patients with stomach cancer. METHODS: Forty patients were randomly assigned to sevoflurane-remifentanil group (group S) and propofol-remifentanil group (group P). Anesthesia was maintained with balanced anesthesia (group S) or TIVA (group P). We measured the IL-6, TNF-alpha, cortisol and performed laboratory tests before (T1) and after surgery (T2). RESULTS: Concentration of IL-6 and cortisol increased (group S 1.89 +/- 1.69 pg/ml to 47.11 +/- 44.37 pg/ml, 10.68 +/- 4.89 pg/ml to 14.93 +/- 6.79 pg/ml, group P 1.74 +/- 1.60 pg/ml to 61.58 +/- 48.65 pg/ml, 9.96 +/- 4.40 pg/ml to 14.27 +/- 7.43 pg/ml, respectively) postoperatively in both groups, but there were not different between group S and group P. There were no differences of TNF-alpha between T1 and T2 in both groups. Changes of other laboratory values were indifferent between groups. CONCLUSIONS: The effects of sevoflurane-remifentanil balanced anesthesia and propofol-remifentanil TIVA on postoperative stress responses in patients with stomach cancer were not different. Further investigations are required to assess the effects of anesthetics on other stress response profiles and such significances.