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ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 446-454

A randomized trial comparing three different anesthetic techniques on immune response for patients undergoing abdominal hysterectomy operation


Department of Anesthesia and Intensive Care, Al-Azhar University

Correspondence Address:
Amira Abdelfattah Shabaan
Assistant Professor of Anesthesia and Intensive Care, Department of Anesthesia and Intensive Care, Al-Azhar University

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_55_18

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Background In the past decade, the published studies indicated that different anesthetic techniques may have different effects on the immune response of patients undergoing the same type of surgery. The aim of the work was to evaluate the effects of three anesthetic techniques [sevoflurane anesthesia, total intravenous anesthesia (TIVA) with propofol, and epidural anesthesia with bupivacaine] on interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IL-10 in patients undergoing abdominal hysterectomy operation. Patients and methods A total of 60 female patients with an age range of 39–60 years old and American Society of Anesthesiologists status I and II were scheduled for an elective abdominal hysterectomy. They were allocated randomly into three equal groups (n=20): general anesthesia with sevoflurane (group I), TIVA anesthesia (group II), and epidural anesthesia (group III). Vital signs (heart rate and mean arterial blood pressure) were recorded at the baseline and every 10 min. IL-6, IL-10, and TNF-α were also recorded just before the induction of anesthesia and then at 2 and 24 h after the end of the surgery. Results Mean arterial pressure and heart rate showed no statistically significant differences between the three groups. The IL-6 was highly significantly increased at 2 and 24 h after surgery in all groups, but the increase was less in the epidural group in comparison with sevoflurane and TIVA groups. The TNF-α was highly significantly increased at 2 h in all groups in comparison with the preoperative value. This increase was more increased in sevoflurane group in comparison with TIVA and epidural groups. IL-10 increased significantly in epidural group 2 and 24 h after surgery in comparison with sevoflurane group and TIVA group. IL-10 was significantly higher in TIVA group than inhalation group 2 and 24 h after surgery. Conclusion Epidural anesthesia had a better profile in relation to cytokine levels, whereas propofol had little effects on the immune response compared with sevoflurane anesthesia in patients undergoing abdominal hysterectomy operation.


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