title: The effect of tramadol on serum cytokine response in patients undergoing pulmonary lobectomy.
abstract: OBJECTIVE
  To investigate the effect of tramadol on the production of serum interleukin (IL) 6, IL-10, and IL-2 and soluble (s) IL-2 receptor (R), thereby evaluating its effects on the proinflammatory and anti-inflammatory responses and immune function in cancer patients undergoing conventional pulmonary lobectomy.
  
  
  METHODS
  Randomized, double-blinded, placebo-controlled study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Forty ASA physical status I and II adult patients scheduled for conventional pulmonary lobectomy.
  
  
  METHODS
  Patients were randomly divided into 2 groups (n = 20 in each group). Both groups received general anesthesia with enflurane combined with epidural blockade. At 5 minutes before skin incision, patients were given either tramadol 1.5 mg/kg intravenously (IV), followed by a continuous infusion of 0.5 mg/kg per hour until the end of surgery (group I), or IV normal saline (group II).
  
  
  RESULTS
  Venous blood samples for the measurement of serum cytokine concentrations were taken before anesthesia and at set intervals until 24 hours after operation. Serum levels of IL-6 and IL-10 in both groups were increased significantly during and after operation compared with baseline levels (P < .05). No statistical differences between groups in terms of IL-6 and IL-10 were observed. Levels of IL-2 were elevated significantly at 4 hours after operation in group I as compared with baseline levels (P < .001), whereas they remained low at 4 and 24 hours after operation in group II (P < .01). There were significant increases in levels of sIL-2R at 4 and 24 hours after operation in group II as compared with baseline levels (P < .05) and at 24 hours after operation in group I (P < .01). Levels of IL-2 were higher at 4 and 24 hours after operation in group I than in group II (P < .01). Levels of sIL-2R were lower at 4 hours after operation in group I than in group II (P < .01).
  
  
  CONCLUSIONS
  IV infusion of tramadol does not seem to alter IL-6/IL-10 cytokine response to pulmonary lobectomy. As tramadol was associated with increased IL-2 and delayed enhancement of sIL-2R in our study, it may attenuate to some extent an impaired immune response in pulmonary lobectomy.
authors.affiliation: Department of Anesthesiology, The Third Clinical Hospital, Harbin Medical University, Harbin, Heilongjiang Province 150040, China. wangguonian609cn@yahoo.com.cn
authors.forename: Guonian
authors.initials: G
authors.lastname: Wang
authors.forename: Yiqi
authors.initials: Y
authors.lastname: Weng
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ishiguro
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Shigeho
authors.initials: S
authors.lastname: Morita
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D016207:Cytokines / Q000097:blood*; D004311:Double-Blind Method; D004737:Enflurane; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D018664:Interleukin-12 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008168:Lung / Q000601:surgery*; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013510:Pulmonary Surgical Procedures; D015375:Receptors, Interleukin-2 / Q000187:drug effects; D014147:Tramadol / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D016207:Cytokines; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D016753:Interleukin-10; D018664:Interleukin-12; D014147:Tramadol; D004737:Enflurane