Increasing evidence suggests that many of the systemic responses that occur after injury and infection are related to elabolation of cytokines by the host. Cytokines are a diverse group of polypeptides released from activated reticuloendothelial
cells,
which have multiple biological activities. But there is a paucity of information on the effect of anesthesia on plasma cytokine levels and little information on cytokine release following surgery.
We studied plasma cytokine levels and hemodynamic parameters during anesthesia, surgery, and post operation 1 day. Sixty patients were studied. Patients were divided into two groups (G: general anesthesia with isoflurane, E:epidural anesthesia
with
0.5%
bupivacaine) according to the method of anesthesia. Venous samples wee collected at the following time: a baseline sample 30 minutes before induction of anesthesia, at 10 minutes after induction of anesthesia, at 30 minutes after the induction of
surgery. At 30 minutes after the end of anesthesia, and at 24 hours after the end of anesthesia. Arterial blood pressure and heart rate were measured at all time. Eight mililiter of peripheral blood was obtained for interleukin-6 studies in plain
tubes.
Plasma concentration of IL-6 was measured by IL-6 ELISA kit(Amershem Life Science, England).
@ES The results were as follows:
@EN 1) IL-6 did not change during general anesthesia but increased 30~40 fold at 30 minutes after the end of anesthesia and at 24 hours after the end of anesthesia.
2) IL-6 did not change during epidural anesthesia but increased 10~40 fold at 30 minutes after the end of operation and at 24 hours after the end of operation.
3) Arterial blood pressure and heart rate were unchanged during this experiment and there were no relationships between the change of interleukin-6 level and the arterial blood pressure and heart rate.
The results suggest that the increment of IL-6 levels may be induced by the tissue damage or reaction of stress in operation with anesthesia. Isoflurane, N2O and bupivacaine, however, may not increase the IL-6 level.
Further researches will be needed that the effects of other anesthetics selection except isoflurane and bupivacane to IL-6 level and immunological mechanism. (Korean J Anestesiol 1995; 29: 76~83).
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