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. doi: 10.1177/0310057X0803600113.

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia / methods*
  • Anesthesia, Inhalation / methods
  • Anesthesia, Intravenous / methods
  • Anesthetics, Inhalation / pharmacology
  • Anesthetics, Intravenous / pharmacology
  • Cholecystectomy*
  • Cytokines / blood
  • Cytokines / drug effects*
  • Female
  • Humans
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Isoflurane / pharmacology*
  • Male
  • Middle Aged
  • Piperidines / pharmacology*
  • Propofol / pharmacology*
  • Remifentanil
  • Time Factors
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / drug effects

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Cytokines
  • Interleukin-6
  • Piperidines
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Isoflurane
  • Remifentanil
  • Propofol