Effects of Different Pneumoperitoneum Pressures on IL-1, IL-6, and TNF-α / 中国微创外科杂志

ABSTRACT

Objective To explore the effects of different pressures of carbon dioxide pneumoperitoneum under laparoscopic surgery on IL-1β, IL-6, and TNF-α. Methods Ninety patients with ASA Ⅰor Ⅱwho were scheduled to elective operation under laparoscopic surgery from October 2010 to June 2012 were randomly divided into three groups .After endotracheal intubation , different carbon dioxide pressures , 10 mm Hg, 12 mm Hg, and 15 mm Hg, were orderly given to group 1, 2, and 3 to build pneumoperitoneum .The serum levels of IL-1β, IL-6, and TNF-α, as well as hemodynamic parameters , were assessed at the time after anesthesia ( T0 ) , after pneumoperitoneum development ( T1 ) , of position placement before operation ( T2 ) , after dismissing pneumoperitoneum (T3), and 24 hours after operation (T4), respectively. Results The measures of MAP, HR, and PETCO2 had no significant differences between each other of the three groups ( P >0.05), and the MAP and HR results showed significant differences among the three groups at different time points (P0.05).There were statistical significances between the three groups in levels of IL-1β, IL-6, and TNF-αat time points of T1 , T2 , T3 , and T4 , respectively (P0.05).In the group 3, the levels of IL-6 were significantly higher at time points of T 1, T2, and T3 than at T0(P<0.05).In the group 2 and group 3, the levels of TNF-αat T1, T2, and T3 were significantly different from at T0(P<0.05), whereas in the group 1, significant difference was seen only between the time points of T 0 and T1(P<0.05). Conclusion Low pneumoperitoneum pressure leads to minor stress effects .A 10 mm Hg carbon dioxide pneumoperitoneum is recommended .