title: Comparing the effects of minimal low-flow desflurane with that of semi-close high flow desflurane on perioperative cytokine response in patients undergoing gastrectomy.
abstract: BACKGROUND
  Anesthetic techniques may influence the perioperative cytokine response. We investigate two anesthetic techniques: minimal low-flow anesthesia (LFA) and semi-closed high flow anesthesia (HFA) with desflurane on the effect of cytokine response in gastrectomy.
  
  
  METHODS
  Forty patients scheduled to undergo elective gastrectomy were randomly allocated to LFA (0.3 mL/min) or HFA (2 L/min) group. Blood was sampled for measurement of tumor necrosis factor (TNF), interleukin (IL)-6, IL-8, and IL-1 receptor antagonist (RA) at scheduled intervals. Hemodynamic responses, desflurane concentrations, numbers of patient using cardiovascular agents, and frequency of vaporizer manipulations were recorded during the operation.
  
  
  RESULTS
  For patients in the LFA group, production of IL-8 was significantly less increased at the end of the surgical procedure; however there was no significant difference in total production between groups. There was no significant difference in TNF, IL-6, and IL-1RA production throughout the observed period. The desflurane vaporizer was adjusted more frequently (4 [13-6] versus 2 [1-3] times) for patients in the HFA group, and more patients in this group required the use of cardiovascular agents (10 versus 4) than patients in the LFA group during the operation.
  
  
  CONCLUSIONS
  The current study demonstrates that smaller increase in cytokine production in the LFA than HFA with desflurane for the patients receiving gastrectomy.
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sheen
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Yang
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Liu
authors.forename: Cecil O
authors.initials: CO
authors.lastname: Borel
authors.forename: Chih-Shung
authors.initials: CS
authors.lastname: Wong
authors.forename: Shung-Tai
authors.initials: ST
authors.lastname: Ho
authors.forename: Ching-Tang
authors.initials: CT
authors.lastname: Wu
mesh_terms: D000368:Aged; D000764:Anesthesia, Closed-Circuit; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D016207:Cytokines / Q000096:biosynthesis*; D000077335:Desflurane; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007375:Interleukin-1 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D016209:Interleukin-8 / Q000096:biosynthesis; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged
chemical_list: D018685:Anesthetics, Inhalation; D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D000077335:Desflurane; D007530:Isoflurane