[Comparison of two types of anesthesia on plasma levels of inflammatory markers].
BACKGROUND
The aim of this work was to determine and compare plasma levels of proinflammatory cytokines (IL-1beta, IL-6 and TNF-alpha), C-reactive protein (CRP) and lipoperoxides in patients submitted to laparoscopic cholecystectomy under general anesthesia or regional anesthesia.


METHODS
Two groups of 15 patients of both sexes were submitted to laparoscopic cholecystectomy either with general or regional anesthesia. In all cases we obtained three samples of plasma. The first sample was collected immediately before surgery, whereas the other samples were collected 60 min and 24 h after the cholecystectomy. Using commercial kits, plasma levels of IL-1beta, IL-6 and TNF-alpha were quantified by ELISA, whereas lipoperoxides were determined by a colorimetric method. The ultrasensitive CRP was determined in the hospital by the Prestige 24I automated method.


RESULTS
In all determinations, proinflammatory cytokines increased 24 h after surgery except plasma levels of IL-1beta in the regional anesthesia group. Comparison of the two different groups showed that the general anesthesia group had a similar or higher quantity of proinflammatory cytokines and oxidative stress when compared to the regional anesthesia group (p <0.05). In contrast, plasma levels of CRP were lower in the general anesthesia group (p <0.005).


CONCLUSIONS
The type of anesthesia influences in a different manner the secretion of soluble mediators of inflammation. These observations may have important clinical repercussions.
Bravo-Cuéllar
Alejandro
A
Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social. Universidad de Guadalajara. abravoc@prodigy.net.mx
Romero-Ramos
José Enrique
JE
Hernández-Flores
Georgina
G
Romo-Pérez
Felipe de Jesús
Fde J
Bravo-Cuéllar
Luis
L
Lerma-Díaz
José Manuel
JM
D000328:Adult; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000209:etiology; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008054:Lipid Peroxides / Q000097:blood; D008297:Male; D011184:Postoperative Period; D016037:Single-Blind Method; D013346:Subarachnoid Space; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D015415:Biomarkers; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D008054:Lipid Peroxides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein