The effects of abdominal wall-lifting technique, pneumoperitoneum and different anesthesia methods on serum cytokines levels in gynecological patients underwent laparoscopic operation

• DOI: 10.3760/cma.j.issn.1673-4378.2011.12.009
• Publication Date: 2011-12-15
• Authors: Chuanbao Han; Yu Li; Xia Wu; Qinhai Zhou; Yanning Qian
• Keywords: Interleukin 8

Objective To study the variation of serum interleukin-6 (IL-6),interleukin-10 (IL-10),tumor necrosis factor alpha(TNF-α) and heat shock protein 70(HSP70) in patients underwent gynecological laparoscopic operations using abdominal walllifting(a gasless technique) or pneumoperitoneum methods under different anesthesia.Methods Fifty-seven scheduled for laparoscopy,with operation time less than 100 min,were randomly divided into three groups ( Ⅰ,Ⅱ,Ⅲ ) with 19cases each group respectively.Group Ⅰ were operated CO2 pneuioperitoneum laparoscopy general anesthesia.Group Ⅱ anesthesia wall-lifting technique.Group Ⅲ went through same operative procedures as Ⅱ,but epidural anesthesia.Serum levels IL-6,IL-10,TNF-α HSP70 all monitored at four points:before (Tt),30 min after establishment (T2),10min it's removal (T3),and 8 am on following day (T4).Results There no significant difference among T1(P＞0.05).The these indexes increased beginning operations,and reaching its peak T3 values T4 Ⅲ.The level T NF-α[(31±I4) pg/L] was higher that [(24±10) T2(P＜0.05).At point T3,serum IL-6[(46±8)pg/L],TNF-α[(54±18) pg/L HSP70[(3.18±0.58) μg/L] significantly those[ (39±6) pg/L,(36±17) pg/L,(2.30±0.29) (P＜0.01),and so ratio IL-6/IL-10(P＜0.05 ).Meanwhile,the concentrations IL-6[(27±10) TNF-α [(24±7) lower those Ⅱ[ (P＜0.05).Conclusion Gynecological method can avoid effect reduce stress response during operation.Compared to anesthesia,less seen anesthesia.

Key words: Anesthesia,general; Anesthesia,epidural; Laparoscopic surgery; CO2 insufflation; Stress