Changes of interleukin-6 and related factors as well as gastric intramucosal pH during colorectal and orthopaedic surgical procedures.
OBJECTIVE
To investigate the changes of perioperative serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures.


METHODS
Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation. Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol. pHi and plasma lactate were also measured at the same time points.


RESULTS
Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation. CRP was not detectable until the first day after operation. Peak concentration of IL-6 had positive relationship with CRP. These variables changed more significantly in colorectal group than that in orthopaedic group (P < 0.05). pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P < 0.05).


CONCLUSIONS
IL-6 may reflect tissue damage more sensitively than CRP. Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.
Hong
Xi
X
Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730. hongxihxcn@yahoo.com
Ye
Tie-hu
TH
Zhang
Xiu-hua
XH
Ren
Hong-zhi
HZ
Huang
Yu-guang
YG
Bu
Yu-Fen
YF
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006863:Hydrogen-Ion Concentration; D015850:Interleukin-6 / Q000097:blood*; D007405:Intervertebral Disc Displacement / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D013130:Spinal Stenosis / Q000097:blood* / Q000503:physiopathology / Q000601:surgery
D015850:Interleukin-6; D019344:Lactic Acid; D002097:C-Reactive Protein; D006854:Hydrocortisone