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

• Published in: Anaesthesia and intensive care Vol. 36; no. 1; pp. 74 - 78
• Main Authors: Ke, J. J., Zhan, J., Feng, X. B., Wu, Y., Rao, Y., Wang, Y. L.
• Format: Journal Article
• Language: English
• Published: Edgecliff Anaesthesia and Intensive Care 01.01.2008; Sage Publications Ltd. (UK); Sage Publications Ltd
• Subjects: Anesthesia; Anesthesia - methods; Anesthesia, Inhalation - methods; Anesthesia, Intravenous - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - pharmacology; Anesthetics, Intravenous - pharmacology; Biological and medical sciences; Chemical properties; Cholecystectomy; Cytokines; Cytokines - blood; Cytokines - drug effects; Dosage and administration; Female; General anesthetics; Health aspects; Humans; Interleukin-10 - blood; Interleukin-6 - blood; Isoflurane - pharmacology; Male; Medical sciences; Middle Aged; Physiological aspects; Piperidines - pharmacology; Propofol - pharmacology; Remifentanil; Time Factors; Tumor Necrosis Factor-alpha - blood; Tumor Necrosis Factor-alpha - drug effects; China; Agonist; Intravenous administration; μ Opioid receptor; Opiates; Narcotic analgesic; interleukin-10; Remifentanil; interleukin-6; Necrosis; Interleukin 6; total intravenous anaesthesia; Anticytokine; Anesthesia; Tumor; Propofol; Sedative; Halogen Organic compounds; Volatile compound; Cholecystectomy; Human; tumour necrosis factor-a; Antiinflammatory agent; Isoflurane; General anesthetic; Interleukin 10; Phenylpiperidine derivatives; Comparative study
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057X0803600113

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-α (TNF-α), interleukin IL-6 and interleukin IL-10 were measured during and after surgery. The proinflammatory cytokine levels (TNF-α 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-α 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.