Paravertebral block can attenuate cytokine response when it replaces general anesthesia for cancer breast surgeries

ABSTRACT

Cytokine release is a well-known response to surgery especially when it is linked to cancer. Paravertebral block [PVB] is the suitable regional anesthesia for breast surgery. We tested the effect of replacing general anesthesia [GA] with PVB on cytokine response during and after surgeries for cancer breast. Controlled randomized study. Forty cancer breast patients were divided in two groups; Group 1 received PVB and Group 2 received GA during performance of unilateral breast surgery without axillary clearance. Plasma concentrations of interleukin [IL]-6, IL-10, IL-12 and interferon-gamma [IFN-gamma] were measured and IL-10/IFN-gamma were estimated in the following points; before starting PVB in Group 1 or induction of GA in Group 2 [Sample A], before skin incision [Sample B], at the end of procedure before shifting out of operating room [Sample C], 4-h post-operatively [Sample D] and 24-h post-operatively [Sample E]. unpaired Student t-test. IL-6 increased progressively in both groups with statistically significant lower levels in samples C and D in Group 1. IL-10 levels showed progressive increasing in both groups without differences between groups. IL-12 showed progressive decrease in both groups with statistically significant higher levels in samples C and D in Group 1. IFN-levels showed significantly higher levels in samples C and D in Group 1. IL-10/IFN-gamma ratio was significantly lower in Group 2 in samples C and D. Replacing GA with PVB can attenuate cytokines response to cancer breast surgeries