Cytokine Profile in Patients Undergoing Minimally Invasive Surgery with Balanced Anesthesia
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Cytokine Profile in Patients Undergoing Minimally Invasive Surgery with Balanced Anesthesia José Eduardo B. Orosz,1 Mariana G. Braz,2 Márjorie A. Golim,3 Márcio Antônio A. Barreira,1 Denise Fecchio,2 Leandro G. Braz,1 and José Reinaldo C. Braz1,4
Abstract—Patients undergoing surgical procedure develop an inflammatory response due to surgical trauma that may be modulated by anesthetics. The aim of this study was to investigate the cytokine profile in the plasma of adult patients who underwent minimally invasive surgery with balanced anesthesia with propofol, fentanyl, and sevoflurane. The study included 15 healthy patients scheduled for tympanoplasty or septoplasty under balanced anesthesia. Blood samples were drawn at four time points: before anesthesia, before surgery, 120 min after anesthesia induction, and on the first postoperative day. Plasma interleukin (IL)-1β, -2, -4, -6, -8, -10, -12, TNF-α, and INF-γ levels were assessed by flow cytometry. IL-6 levels were elevated on the day after the surgery (p0.05). In conclusion, balanced anesthesia with propofol, fentanyl, and sevoflurane anesthesia is not associated with intraoperative changes in the plasma cytokines in healthy patients undergoing minimally invasive otorhinological surgeries. Considering IL-6 results, a postoperative inflammatory response may have occurred due to surgical stress. KEY WORDS: balanced anesthesia; sevoflurane; minor surgical procedures; cytokines; flow cytometry.
INTRODUCTION Inflammation is a fundamental process for tissue reconstitution, but an overactive inflammatory response can be more dangerous than protective, leading to postop1
Department of Anesthesiology, Botucatu Medical School, UNESP, Universidade Estadual Paulista, District of Rubiao Junior, Botucatu, São Paulo, BrazilCEP: 18618-970 2 Department of Anesthesiology, Botucatu Medical School, UNESP, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil 3 Blood Center, Botucatu Medical School, UNESP, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil 4 To whom correspondence should be addressed at Department of Anesthesiology, Botucatu Medical School, UNESP, Universidade Estadual Paulista, District of Rubiao Junior, Botucatu, São Paulo, BrazilCEP: 18618-970. E-mail: [email protected] ABBREVIATIONS: SEVO, Sevoflurane; IL, Interleukin; TNF-α, Tumor necrosis factor alpha; INF-γ, Interferon gamma; ASA, American Society of Anesthesiologists; SpO2, Peripheral oxygen saturation; PETCO2, End-tidal of carbon dioxide; PACU, Post-Anesthesia Care Unit; CBA, Cytometric bead array; PerCP, Peridinin chlorophyll-protein complex; PE, Phycoerithrin; ANOVA, Analysis of variance; SD, Standard deviations; ELISA, Enzyme-linked immunosorbent assay; EDTA, Ethylenediamine tetraacetic acid; BMI, Body mass index; N2O, Nitrous oxide; Th1/Th2, T helper 1/T helper 2 lymphocytes
erative complications, such as postoperative infections, wound healing disturbances, and multiple organ dysfunctions [1]. Surgery, trauma, and anesthetics may contribute to the inflammation. Thus, it is important to acknowledge w
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