Stress response under continuous infusion of remifentanil compared to bolus doses of fentanyl assessed by levels of cytokines, C-reactive protein, and cortisol during and after abdominal hysterectomy
OBJECTIVES: Surgery and anesthetic method have immunomodulating effects on hemodynamic response and stress. We compared the effects of 2 intraoperative analgesic regimens on patients undergoing abdominal hysterectomy.
MATERIAL AND METHODS: We conducted a randomized double-blind trial in ASA 1 and 2 patients undergoing abdominal hysterectomy under balanced anesthesia. Twenty-nine patients were randomized to 2 groups. One group received analgesia by infusion of remifentanil plus morphine and nonsteroidal anti-inflammatory drugs as rescue medications; the other received conventional analgesia with bolus doses of fentanyl according to changes in hemodynamic variables. We measured levels of proinflammatory (interleukin [IL]-6) and antiinflammatory (IL-10) cytokines, cortisol, and C-reactive protein preoperatively, at incision, and at 1, 4 and 24 hours after surgery.
RESULTS: There were no significant differences between the 2 groups in terms of the markers studied at baseline. In each group, however, there were significant changes from baseline at the various points in time. IL-6 and IL-10 levels were significantly elevated (P < .05) at 4 hours. The changes in cortisol levels were significantly different at 1 and 4 hours. Finally, there were significant increases in C-reactive protein at 24 hours.
CONCLUSIONS: Unlike other clinical trials, our study detected no differences between the 2 techniques in response to surgical stress evaluated by analyzing concentrations of pro- and anti-inflammatory cytokines, cortisol, and C-reactive protein.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2007 |
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| Erschienen: |
2007 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Revista espanola de anestesiologia y reanimacion - 54(2007), 4 vom: 31. Apr., Seite 221-6 |
| Sprache: |
Spanisch |
|---|
| Weiterer Titel: |
Estudio de la respuesta al estrés en dos técnicas analgésicas (remifentanilo continuo frente a fentanilo en bolos) valorando diferentes marcadores (citocinas, proteína C reactiva y cortisol) en el intra y postoperatorio de histerectomías abdominales |
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| Beteiligte Personen: |
Rodríguez, R [VerfasserIn] |
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| Anmerkungen: |
Date Completed 09.08.2007 Date Revised 01.12.2018 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM170436535 |
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| 245 | 1 | 0 | |a Stress response under continuous infusion of remifentanil compared to bolus doses of fentanyl assessed by levels of cytokines, C-reactive protein, and cortisol during and after abdominal hysterectomy |
| 246 | 3 | 3 | |a Estudio de la respuesta al estrés en dos técnicas analgésicas (remifentanilo continuo frente a fentanilo en bolos) valorando diferentes marcadores (citocinas, proteína C reactiva y cortisol) en el intra y postoperatorio de histerectomías abdominales |
| 264 | 1 | |c 2007 | |
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| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 09.08.2007 | ||
| 500 | |a Date Revised 01.12.2018 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Surgery and anesthetic method have immunomodulating effects on hemodynamic response and stress. We compared the effects of 2 intraoperative analgesic regimens on patients undergoing abdominal hysterectomy | ||
| 520 | |a MATERIAL AND METHODS: We conducted a randomized double-blind trial in ASA 1 and 2 patients undergoing abdominal hysterectomy under balanced anesthesia. Twenty-nine patients were randomized to 2 groups. One group received analgesia by infusion of remifentanil plus morphine and nonsteroidal anti-inflammatory drugs as rescue medications; the other received conventional analgesia with bolus doses of fentanyl according to changes in hemodynamic variables. We measured levels of proinflammatory (interleukin [IL]-6) and antiinflammatory (IL-10) cytokines, cortisol, and C-reactive protein preoperatively, at incision, and at 1, 4 and 24 hours after surgery | ||
| 520 | |a RESULTS: There were no significant differences between the 2 groups in terms of the markers studied at baseline. In each group, however, there were significant changes from baseline at the various points in time. IL-6 and IL-10 levels were significantly elevated (P < .05) at 4 hours. The changes in cortisol levels were significantly different at 1 and 4 hours. Finally, there were significant increases in C-reactive protein at 24 hours | ||
| 520 | |a CONCLUSIONS: Unlike other clinical trials, our study detected no differences between the 2 techniques in response to surgical stress evaluated by analyzing concentrations of pro- and anti-inflammatory cytokines, cortisol, and C-reactive protein | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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