Effect of propofol and sevoflurane on the inflammatory response of patients undergoing craniotomy

BMC Anesthesiology

Research Article

Jasmina Markovic-Bozic¹  Iztok Potocnik¹  Vesna Novak-Jankovic¹  Andrej Vranic²  Blaz Karpe³  Ales Jerin⁴ 

[1] Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Zaloska 7, SI-1000, Ljubljana, Slovenia;Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia;Service de Neurochirurgie, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France;Faculty of Natural Science and Engineering, University of Ljubljana, Ljubljana, Slovenia;Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia;

关键词: Craniotomy;    Propofol;    Sevoflurane;    Interleukin 6;    Interleukin 8;    Interleukin 10;   

DOI  :  10.1186/s12871-016-0182-5

 received in 2015-08-11, accepted in 2016-02-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe purpose of this randomised, single-centre study was to prospectively investigate the impact of anaesthetic techniques for craniotomy on the release of cytokines IL-6, IL-8, IL-10, and to determine whether intravenous anaesthesia compared to inhalational anaesthesia attenuates the inflammatory response.MethodsThe study enroled 40 patients undergoing craniotomy, allocated into two equal groups to receive either sevoflurane (n = 20) or propofol (n = 20) in conjunction with remifentanil and rocuronium. The lungs were ventilated mechanically to maintain normocapnia. Remifentanil infusion was adjusted according to the degree of surgical manipulation and increased when mean arterial pressure and the heart rate increased by more than 30 % from baseline. The depth of anaesthesia was adjusted to maintain a bispectral index (BIS) of 40–60. Invasive haemodynamic monitoring was used. Serum levels of IL-6, IL-8 and IL-10 were measured before surgery and anaesthesia, during tumour removal, at the end of surgery, and at 24 and 48 h after surgery. Postoperative complications (pain, vomiting, changes in blood pressure, infection and pulmonary, cardiovascular and neurological events) were monitored during the first 15 days after surgery.ResultsCompared with patients anaesthetised with sevoflurane, patients who received propofol had higher levels of IL-10 (p = 0.0001) and lower IL-6/IL-10 concentration ratio during and at the end of surgery (p = 0.0001). Both groups showed only a minor response of IL- 8 during and at the end of the surgery (p = 0.57).ConclusionsPatients who received propofol had higher levels of IL-10 during surgery. Neither sevoflurane nor propofol had any significant impact on the occurrence of postoperative complications. Our findings should incite future studies to prove a potential medically important anti-inflammatory role of propofol in neuroanaesthesia.Clinical trial registrationIdentified as NCT02229201 at www.clinicaltrials.gov

【 授权许可】

CC BY   
© Markovic-Bozic et al. 2016