Effects of extradural anaesthesia on interleukin-6 and acute phase response to surgery.
Serum concentrations of the cytokine, interleukin-6 (IL-6), increase after surgical trauma. IL-6 mediates the synthesis of acute phase proteins and stimulates secretion of pituitary hormones. We have examined the time course of circulating IL-6, and cortisol and growth hormone responses in patients undergoing hysterectomy to determine if IL-6 contributes to the early pituitary hormone changes found during surgery. One group (n = 8) received a standardized general anaesthetic while the remaining patients (n = 8) received extradural analgesia to T4-S5 in addition to a similar general anaesthetic. In the general anaesthesia group, there was a significant increase in serum cortisol and growth hormone concentrations before any changes in IL-6 were detected. Furthermore, in the extradural group, in whom these hormonal responses were attenuated, circulating IL-6 concentrations did not differ significantly from the general anaesthesia group. There were no significant differences between the groups in the acute phase response, as measured by circulating concentrations of C-reactive protein and zinc, but the expected effects of extradural block on circulating metabolites and white cell count were demonstrated. We conclude that IL-6 is unlikely to contribute to the initial increases in secretion of pituitary hormones found during surgery, but a later effect of the cytokine on endocrine responses cannot be excluded.
Moore
C M
CM
Department of Anaesthetics, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Desborough
J P
JP
Powell
H
H
Burrin
J M
JM
Hall
G M
GM
D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006400:Hematocrit; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007044:Hysterectomy; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007773:Lactates / Q000097:blood; D007958:Leukocyte Count; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis; D015032:Zinc / Q000097:blood
D000209:Acute-Phase Proteins; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D015850:Interleukin-6; D007773:Lactates; D012709:Serum Albumin; D013006:Growth Hormone; D002097:C-Reactive Protein; D015032:Zinc; D006854:Hydrocortisone