A randomized study of maternal serum cytokine levels following cesarean section under general or neuraxial anesthesia

Dermitzaki, Eleni; Staikou, Chryssoula; Petropoulos, G.; Rizos, D.; Siafaka, Ioanna; Fassoulaki, Argyro

doi:10.1016/j.ijoa.2008.07.005

Cited by 21 publications

(19 citation statements)

References 21 publications

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“…Multiple studies found that anesthetic agents had significant influence on serum cytokines in patients who underwent surgeries (Dermitzaki et al, 2009;Reikerås et al, 2010). Propofol, as one of the anesthetic agents commonly used in clinic, has favorable sedation, anti-inflammatory responses and anti-oxidation characteristics (Cavalca et al, 2008;Gonzalez-Correa et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Influence of Propofol, Isoflurane and Enflurance on Levels of Serum Interleukin-8 and Interleukin-10 in Cancer Patients

Liu

2014

Asian Pacific Journal of Cancer Prevention

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Objective: To observe the influence of propofol, isoflurane and enflurance on interleukin-8 (IL-8) and IL-10 levels in cancer patients. Methods: Ninety cancer patients with selective operation from March 2011 to May 2014 were randomly divided into group A (34 cases), group B (28 cases) and group C (28 cases). Intramuscular injections of scopine hydrochloride and phenobarbital sodium were routinely conducted to 3 groups. After general anesthesia was induced, tracheal intubations were given. During the maintenance of anesthesia, 0.5~1.0 mg/ kg propofol was intravenously injected to group A discontinuously, while continuous suctions of isoflurane and enflurance were subsequently performed to group B and C correspondingly. Clinical outcomes, postoperative complications as well as serum IL-8 and IL-10 levels before operation (T0), at the time of skin incision (T1), 3 h after the beginning of the operation (T2) and 24 h (T3) and 72 h (T4) after the operation were observed among 3 groups. Results: Operations in all groups were successfully completed. The rates of surgery associated complications were 8.82% (3/34), 7.14% (2/28) and 7.14% (2/28) in group A, B and C, respectively, and there were no significant differences (P>0.05). Serum IL-8 and IL-10 levels increased gradually from the beginning of the operation and reached the peak at T3, and were evidently higher at each time point than at T0 (P<0.01). At T1, serum IL-8 and IL-10 levels had no significant differences among 3 groups (P>0.05), but the differences were significant at T2, T3 and T4 (P<0.05). Moreover, correlation analysis suggested that serum IL-8 level was in positive relation with IL-10 level (r=0.952, P<0.01). Conclusions: Propofol, which is better in inhibiting serum IL-8 secretion and improving IL-10 secretion than isoflurane and enflurance, can be regarded as a preferable anesthetic agent in inhibiting traumatic inflammatory responses.

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Section: Discussionmentioning

confidence: 99%

Influence of Propofol, Isoflurane and Enflurance on Levels of Serum Interleukin-8 and Interleukin-10 in Cancer Patients

Liu

2014

Asian Pacific Journal of Cancer Prevention

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“…We judged this item as low risk of bias in 4 studies, two of which concealed allocation in sealed envelopes (7,10) and two of which by drawing lots (15,18). We judged this item as high risk of Ru-Rong Wang et al …”

Section: Allocation Concealment (Selection Bias)mentioning

confidence: 99%

“…Missing data occupied more than 15% in 2 studies (7,11). As the primary outcomes were low incidence events, so we judged 2 studies as high risk of bias.…”

Section: Incomplete Outcome Data (Attrition Bias)mentioning

confidence: 99%

General versus Neuraxial Anesthesia in Cesarean Section: A Systematic Review

Yang¹,

Xu²,

Yang³

et al. 2017

J Anesth Perioper Med

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Background: Neuraxial anesthesia is preferred anesthesia technique for cesarean section. But recently the safety of general anesthesia improved well. So it is important to clarify the safety of general anesthesia and neuraxial anesthesia for cesarean section. Methods: We searched CENTRAL/Ovid (September, 2016), EMBASE/Ovid (1974 to October 12, 2016, MEDLINE/Ovid (1946 to October 12, 2016. We only included randomized controlled trials (RCTs) which compared general anesthesia versus neuraxial anesthesia including spinal anesthesia, epidural anesthesia or combined spinal and epidural anesthesia in cesarean section. Two authors independently assessed the studies for inclusion, extracted the data and performed the analysis. Results: A total of 1394 mothers were involved in the 15 included studies. For neonatal outcomes, at 1 minute after delivery, Apgar score was significantly lower in maternal general anesthesia group (mean difference[MD] -0.71, 95% confidence intervals [CI] -0.99 to -0.43) and the risk of newborns for Apgar score lower than 7 was higher when the mother underwent general anesthesia (risk ratio [RR] 4.81, 95% CI 1.72 to 13.46). At 5 minutes after delivery, Apgar score was still lower in maternal general anesthesia group (MD -0.31, 95% CI -0.59 to -0.02), but the risk of newborns for Apgar score lower than 7 showed no difference in statistical analysis under general or neuraxial anesthesia (RR 2.31, 95% CI 0.08 to 64.48). Besides, no neonatal deaths were reported, and risk of oxygen by mask or intubation (RR 1.23, 95% CI 0.33 to 4.53) also showed no difference in statistical analysis in both groups. For maternal outcomes, there were more blood loss in general anesthesia group (MD 75.8, 95% CI 21.18 to 130.41), but the risk of receiving postoperative blood transfusion was similar in both groups (RR 2.85, 95% CI 0.93 to 8.72). Besides, the risk of shivering (RR 8.00, 95% CI 1.14 to 56.33), nausea (RR 1.47, 95% CI 0.99 to 2.17) and vomiting (RR 4.13, 95% CI 1.41 to 12.09) was higher in general anesthesia group. But the risk of headache (RR 0.11, 95% CI 0.01 to 0.87) and pruritus (RR 0.13, 95% CI 0.02 to 0.99) was higher in neuraxial anesthesia group. Conclusions: For clinical practice, we recommended neuraxial anesthesia as first choice in cesarean section. For further clinical researches, more non-surrogate outcomes should be reported, such as maternal and neonatal mortality and morbidity.

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“…Tissue damage, surgical stress, and pain cause afferent neuronal stimulation and the activation of cellular and humoral immune pathways that are associated with local inflammatory reactions and the accompanying elevations in the biological mediators such as cytokines (1,2). Proinflammatory cytokines, especially IL-6 and TNF-α, play an important role in the development of hyperalgesia and mechanical allodynia (3).…”

Section: Introductionmentioning

confidence: 99%

Pediatrik Hastalarda Preemptif Epidural İnfüzyonun Postoperatif Ağrı ve Sitokin Cevaba Etkisi

Tütüncü¹,

Erbabacan²,

Korkmaz³

et al. 2013

haseki

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ÖzetAmaç: Cerrahi travma ve ağrı nedeniyle metabolik, endokrin, immün sistemde oluşan değişiklikler sitokin gibi biyolojik mediatörlerin artışı ile beraberdir. Preemptif epidural analjezi, cerrahi travmanın neden olduğu ağrı ve nöromediatörlerin oluşturduğu nörohümoral cevabı etkileyebilir. Bu çalışmada preemptif epidural analjezinin postoperatif ağrı ve sitokin düzeyine etkisinin araştırılması amaçlandı. Yöntem: Ürolojik cerrahi planlanan 60 çocuk; preemptif epidural analjezi (Preempt EA, n=31) grup ve postoperatif epidural analjezi grubu olarak (Postop EA, n=29) randomize iki gruba ayrıldı. Epidural infüzyon; Preempt EA grubunda cerrahi insizyon öncesi, Postop EA grubunda periton kapanışından sonra başlandı. Kan örnekleri preoperatif dönem, cerrahiden 1 saat ve 24 saat sonrasında ELISA yöntemi ile plazma TNF-α ve IL-2 düzeylerini tespit için alındı. Postoperatif ağrı FACES ağrı skalası ile cerrahiden 1 ve 24 saat sonrasında değerlendirildi. Bulgular Abs tractAim: Changes in the metabolic, endocrine, and immune systems caused by surgical trauma and pain are associated with increased concentrations of the biological mediators such as cytokines. Preemptive epidural analgesia may affect pain caused by surgical trauma and the corresponding neurohumoral response induced by the neuromediators. This study investigated the effects of preemptive epidural analgesia on postoperative pain and cytokine levels. Methods:A total of 60 children undergoing urological surgery were randomly assigned to either the preemptive epidural analgesia (Preempt EA, n=31) group or the postoperative epidural analgesia (Postop EA, n=29) group. Epidural infusion was started before the surgical incision in Preempt EA group and after the peritoneal closure in the Postop EA group. Blood samples were collected preoperatively (before anesthesia induction), 1 h and 24 h after surgery. Plasma TNF-α and IL-2 levels were measured by ELISA. Postoperative pain was assessed using the FACES pain scale, and postoperative analgesia was evaluated 1 h and 24 h after surgery.Results: Although TNF-α levels were increased 1 h and 24 h after surgery compared to preoperative levels in both groups, the levels were significantly higher in the Postop EA group. IL-2 levels were significantly higher at both postoperative time points in the Preempt EA group than in the Postop EA group. There were no significant differences in pain scores between the groups. Conclusion:Our results suggest that preemptive epidural analgesia may attenuate the proinflammatory response but has no effect on pain intensity.

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A randomized study of maternal serum cytokine levels following cesarean section under general or neuraxial anesthesia

Cited by 21 publications

References 21 publications

Influence of Propofol, Isoflurane and Enflurance on Levels of Serum Interleukin-8 and Interleukin-10 in Cancer Patients

Influence of Propofol, Isoflurane and Enflurance on Levels of Serum Interleukin-8 and Interleukin-10 in Cancer Patients

General versus Neuraxial Anesthesia in Cesarean Section: A Systematic Review

Pediatrik Hastalarda Preemptif Epidural İnfüzyonun Postoperatif Ağrı ve Sitokin Cevaba Etkisi

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