Effect Of Remifentanyl In Patients Undergoing Thoracic Surgery On Serum Levels Of Interleukin-2 And Interleukin-6

Objective: To compare the effect of remifentanyl and fentanyl on the serum levels of interleukin-2 (IL-2) and interleukin-6 (IL-6) in patients undergoing selective thoracic surgery. Methods: Forty ASA I~II patients were randomized to divided into two groups. remifentanyl group (R) and fentanyl group (F). group(R):Anesthesia was induced with remifentanil2.0μg/kg/min, propoful 1-2mg/kg, vecuronium 0.08-0.12mg/kg, maintained with remifentanil0.2μg/kg/min, propoful 100-200μg/kg/min, vecuronium 0.06mg/kg/h. group (F): Anesthesia was induced with fentanil2.5μg/kg/min, propoful 1-2mg/kg,vecuronium 0.08-0.12mg/kg, maintained with fentanil0.03μg/kg/min, propoful 100-200μg/kg/min, vecuronium 0.06mg/kg/h. Blood samples were taken before skin incision (T1), after chest was opened (T2), 1h after one-lung ventilation (T3), 1h after lungs were inflated(T4) and 3h,12h after operation (T5, T6). Serum levels of IL-2 and IL-6 were measured with radioimmunoassay. All patients received patient-controlled intravenous analgesia (PCIA) with tramadol (group R) and fentanyl (group F). Results There was no significant difference in group R in the serum levels of IL-2 and IL-6.The serum level of IL-6 in group F increased at T2, T3, T4 compared to that before induction (P<0.05), which was no significant difference at T5, T6 compared to that before induction (P>0.05). The serum level of IL-2 in group F decreased at T2, T3, T4 compared to that before induction (P<0.05), which was no significant difference at T5, T6 compared to that before induction (P>0.05). Conclusion: The results suggest that remifentanyl could inhibit stress responseeffectively. In contrast to fentanyl, remifentanyl increases the serum IL-2 level postoperatively, which may cause the immunoenhancement in patients undergoing thoracic surgery. Remifentanyl may be more suitable than fentanyl for perioperative analgesia effect.