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Clinical Research
Anesthetic Pharmacology
Anesthesia and Pain Medicine 2014;9(2):106-109.
Published online April 30, 2014.
Effects of balanced anesthesia with sevoflurane-remifentanil and total intravenous anesthesia with propofol-remifentanil on postoperative stress responses in patients with stomach cancer
Su Hyun Lee, Jong Seok Lee, Hye Jin Kim, Sang Beom Nam
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. sbnam@yuhs.ac
2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Received: 16 October 2013   • Revised: 6 November 2013
Abstract
BACKGROUND
The effects of anesthetics on postoperative stress response remains not fully understood. We evaluated the effects of sevoflurane-remifentanil balanced anesthesia and propofol-remifentanil total intravenous anesthesia (TIVA) on postoperative interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), cortisol, and laboratory test values for patients with stomach cancer.
METHODS
Forty patients were randomly assigned to sevoflurane-remifentanil group (group S) and propofol-remifentanil group (group P). Anesthesia was maintained with balanced anesthesia (group S) or TIVA (group P). We measured the IL-6, TNF-alpha, cortisol and performed laboratory tests before (T1) and after surgery (T2).
RESULTS
Concentration of IL-6 and cortisol increased (group S: 1.89 +/- 1.69 pg/ml to 47.11 +/- 44.37 pg/ml, 10.68 +/- 4.89 pg/ml to 14.93 +/- 6.79 pg/ml, group P: 1.74 +/- 1.60 pg/ml to 61.58 +/- 48.65 pg/ml, 9.96 +/- 4.40 pg/ml to 14.27 +/- 7.43 pg/ml, respectively) postoperatively in both groups, but there were not different between group S and group P. There were no differences of TNF-alpha between T1 and T2 in both groups. Changes of other laboratory values were indifferent between groups.
CONCLUSIONS
The effects of sevoflurane-remifentanil balanced anesthesia and propofol-remifentanil TIVA on postoperative stress responses in patients with stomach cancer were not different. Further investigations are required to assess the effects of anesthetics on other stress response profiles and such significances.
Key Words: Balanced anesthesia, Propofol, Remifentanil, Sevoflurane, Total intravenous anesthesia
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