[Comparison of two types of anesthesia on plasma levels of inflammatory markers]

Abstract

BACKGROUND: The aim of this work was to determine and compare plasma levels of proinflammatory cytokines (IL-1beta, IL-6 and TNF-alpha), C-reactive protein (CRP) and lipoperoxides in patients submitted to laparoscopic cholecystectomy under general anesthesia or regional anesthesia. METHODS: Two groups of 15 patients of both sexes were submitted to laparoscopic cholecystectomy either with general or regional anesthesia. In all cases we obtained three samples of plasma. The first sample was collected immediately before surgery, whereas the other samples were collected 60 min and 24 h after the cholecystectomy. Using commercial kits, plasma levels of IL-1beta, IL-6 and TNF-alpha were quantified by ELISA, whereas lipoperoxides were determined by a colorimetric method. The ultrasensitive CRP was determined in the hospital by the Prestige 24I automated method. RESULTS: In all determinations, proinflammatory cytokines increased 24 h after surgery except plasma levels of IL-1beta in the regional anesthesia group. Comparison of the two different groups showed that the general anesthesia group had a similar or higher quantity of proinflammatory cytokines and oxidative stress when compared to the regional anesthesia group (p <0.05). In contrast, plasma levels of CRP were lower in the general anesthesia group (p <0.005). CONCLUSIONS: The type of anesthesia influences in a different manner the secretion of soluble mediators of inflammation. These observations may have important clinical repercussions.