Effect Of Propofol And Lisoflurane On Perioperative Cytokine Balance During Neurosurgery

Objective:To investigate the effects of propofol and isoflurane on the periopreative serum concentration of IL-6 , TNFα, IL-10 and the balance between pro-and anti-inflammatory cytokines. Methods: Thirty ASA Ⅰ-Ⅱpatients scheduled for neurosurgery were randomly allocated to one of the two groups: isoflurane group (group I) and propofol group (group P) . All the patients were premedicated with intramuscular atropine 0.5mg. In group P anesthesia was induced with propofol 1-2 mg·kg^-1, fentanyl 2-3μg·kg^-1, midazolam 2-3 mg and vecuronium 0. 1～0.15mg·kg^-1 and maintained with propofol 5-10 mg·kg^-1 ·h –1 and intermittent boluses of vecuronium and fentanyl. In group I anesthesiawas induced with 3 %-4 % isoflurane, fentanyl 2-3μg·kg^-1, midazolam 2-3mg, vecuronium 0. 1 ～0.15mg ·kg^-1 and maintained with inhalation isoflurane (ended tidal isoflurane was maintained at 0. 5 MAC) and intermittent boluses of vecuronium. During operation BP and HR were maintained with at ±20% of preanesthesia level. Blood samples were taken from peripheral vein before anesthesia(T1), 2h after skin incision(T2), 2h after operation (T3) and 48h after operation (T4) for determination of serum IL-10, IL-6 and TNFαconcentrations. Results: ①All patients showed significant increases in IL-10 concentration at time point T2,T3.(P<0.01) the IL-10 level decreases to preoperational level at 48h after operation. There are significant difference in IL-10 level at 2h after skin incision and 2h after operation compared to peroperation(P<0.01,P<0.05). ②The proinflammatory cytokine IL-6 levels were similar in both groups . The serum concentration of IL-6 increases significantly at all time point included in this investigation when compared to T1. The IL-6 level of group P is significantly lower than that of group I at 2h after skin incision. ③The serum concentration of TNFαmaintains the same level with preoperation during the entire anaesthesia and operation process. Disscussion: Conclusions: The perioperative cytokine response to surgical trauma and anaesthesia can be modified by the choice of anesthetics. Propofol, being considered to be benefit to brain tissue...