engleski

Cytokine response on surgical stress in spinal anaesthesia

The aim of this study was to assess the effect of spinal anaesthesia on serum concentration of pro-inflammatory and anti-inflammatory cytokines, and cytokines which are secreted by Th1 helper lymphocytes. This study involved 20 patients with ASA status I or II who were scheduled for TURP (transurethral resection of the prostate). Peripheral venous blood samples were collected 2 hours before surgery, on the first, third and fifth postoperative days. We are investigate serum concentrations of cytokines: pro-inflammatory cytokines (IL-1α ; IL-1β ; IL-2 ; IFN-γ ; TNF-α ; IL-6 ; IL-8 ; MCP-1 ; VEGF ; EGF) and anti-inflammatory cytokines (IL-4 ; IL-10) in order to establish differences in patients before and after surgery. Statistically significant differences were found in serum levels of interleukin-6 (IL-6) in spinal (p=0.43) anaesthesia in comparison to preoperative value. Serum concentrations of other proinflammatory cytokines, anti-inflammatory cytokines and cytokines which are secreted by Th1 helper lymphocytes showed no statistical difference before and after surgery under spinal anesthesia. Spinal anaesthesia attenuates stress response and the associated effect on cellular and humoral immunity. Although these effects may be of minor importance for subjects with normal immune system, immunosuppression to tissue injury may have relevance in patients with preexisting immune dysfunctions. References: 1.Carvalho B, Clark DJ, Angst MS Local and systemic release of cytokines, nerve growth factor, prostaglandin E2, and substance P in incisional wounds and serum following cesarean delivery.J Pain. 2008 ; 9:650-72.Maier B, Laurer HL, Rose S, Buurman WA, Marzi I.Physiological levels of pro- and anti-inflammatory mediators in cerebrospinal fluid and plasma: a normative study.J Neurotrauma. 2005 ; 22:822-35 Acknowledgment: This work was supported by grants from the Croatian Ministry of Science (projects: 108-0000000-3433)

cytokine; stress; spinal anaesthesia

doi: 10.1097/AAP.0b013e31826a8366