title: Paravertebral block can attenuate cytokine response when it replaces general anesthesia for cancer breast surgeries.
abstract: BACKGROUND
  Cytokine release is a well-known response to surgery especially when it is linked to cancer. Paravertebral block (PVB) is the suitable regional anesthesia for breast surgery.
  
  
  OBJECTIVE
  We tested the effect of replacing general anesthesia (GA) with PVB on cytokine response during and after surgeries for cancer breast.
  
  
  METHODS
  Controlled randomized study.
  
  
  METHODS
  Forty cancer breast patients were divided in two groups; Group I received PVB and Group II received GA during performance of unilateral breast surgery without axillary clearance. Plasma concentrations of interleukin (IL)-6, IL-10, IL-12 and interferon-γ (IFN-γ) were measured and IL-10/IFN-γ were estimated in the following points; before starting PVB in Group I or induction of GA in Group II (Sample A), before skin incision (Sample B), at the end of procedure before shifting out of operating room (Sample C), 4-h post-operatively (Sample D) and 24-h post-operatively (Sample E).
  
  
  METHODS
  unpaired Student t-test.
  
  
  RESULTS
  IL-6 increased progressively in both groups with statistically significant lower levels in samples C and D in Group I. IL-10 levels showed progressive increasing in both groups without differences between groups. IL-12 showed progressive decrease in both groups with statistically significant higher levels in samples C and D in Group I. IFN-levels showed significantly higher levels in samples C and D in Group I. IL-10/IFN-γ ratio was significantly lower in Group II in samples C and D.
  
  
  CONCLUSIONS
  Replacing GA with PVB can attenuate cytokines response to cancer breast surgeries.
authors.affiliation: Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Sherif S
authors.initials: SS
authors.lastname: Sultan
keywords: Cancer breast; interleukins; paravertebral block