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.

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Ke JJ, Zhan J, Feng XB, Wu Y, Rao Y, Wang YL

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.

Anaesth Intensive Care. 2008 Jan;36(1):74-8.

PubMed ID
18326136 [ View in PubMed
]
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.

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