engleski

Effects of regional and general anaesthesia on serum concentrations of pro-inflammatory and anti-inflammatory cytokines

Nerve-evoked signaling may serve not only for passing information from and to the nervous system, but also for communications within the immune system compartments. Surgical stress and anaesthesia cause immunosuppresion that may predispose patients to postoperative infections and other complications. The aim of this study is to investigate the influence of two established anesthetic techniques: spinal (regional) anaesthesia and general anaesthesia on the perioperative-induced changes of serum concentrations of cytokines: pro-inflammatory cytokines and anti-inflammatory cytokines. This study involved 40 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-1 ; IL-1 ; IL-2 ; IFN- ; TNF- ; IL-6 ; IL-8 ; MCP-1 ; VEGF ; EGF) and anti-inflammatory cytokines (IL-4 ; IL-10). Regional techniques, such as epidural or spinal anaesthesia, with an afferent neural block by local anaesthetics profoundly inhibit hormonal and metabolic stress responses. The surgery-induced inflammation and alteration in cell-mediated immunity seem to be more pronounced after general anaesthesia, possibly secondary to an an enhanced stress response. In particular, regional anaesthesia attenuates this 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. In this article the influence of local anaesthetics on perioperative coagulation and inflamatory response will be reviewed. References: 1. Fischer LG, at al. Anesth Analg 2001 ; 92:1041-7. Fukuda K, at al. 2005. J Physiol 564:21-31

cytokines; anaesthesia

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