title: A comparison of the effect of total intravenous anaesthesia with propofol and remifentanil and inhalational anaesthesia with isoflurane on the release of pro- and anti-inflammatory cytokines in patients undergoing open cholecystectomy.
abstract: The aim of the study was to investigate the effects of two anaesthetic techniques (total intravenous technique vs. inhalational technique) on changes in pro- and anti-inflammatory cytokine levels during open cholecystectomy. Forty ASA PS I-II patients undergoing open cholecystectomy were randomly assigned to two groups. Group R received total intravenous anaesthesia with propofol and remifentanil and group F received balanced inhalational anaesthesia with isoflurane. The plasma levels of tumour necrosis factor-alpha (TNF-alpha), interleukin IL-6 and interleukin IL-10 were measured during and after surgery. The pro-inflammatory cytokine levels (TNF-alpha and IL-6) and the anti-inflammatory cytokine (IL-10) showed a significant increase in their concentrations compared with pre-induction levels in both groups (P < 0.05). By the end of anaesthesia and surgery, TNF-alpha and IL-6 were significantly lower in group R than in group F (P < 0.05). At the end of anaesthesia and 12 hours postoperatively, IL-10 levels in group R were higher than in group F (P < 0.05). These findings suggest that total intravenous anaesthesia using propofol and remifentanil suppresses the inflammatory response caused by surgery to a greater extent than a balanced inhalation technique using isoflurane.
authors.affiliation: Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Hubei Province, Peoples Republic of China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Ke
authors.forename: J
authors.initials: J
authors.lastname: Zhan
authors.forename: X B
authors.initials: XB
authors.lastname: Feng
authors.forename: Y
authors.initials: Y
authors.lastname: Wu
authors.forename: Y
authors.initials: Y
authors.lastname: Rao
authors.forename: Y L
authors.initials: YL
authors.lastname: Wang
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000769:Anesthesia, Inhalation / Q000379:methods; D000771:Anesthesia, Intravenous / Q000379:methods; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D002763:Cholecystectomy; D016207:Cytokines / Q000097:blood / Q000187:drug effects*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007530:Isoflurane / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D000077208:Remifentanil; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000187:drug effects
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D016207:Cytokines; D015850:Interleukin-6; D010880:Piperidines; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007530:Isoflurane; D000077208:Remifentanil; D015742:Propofol