Effects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study
Journal of Cellular & Molecular Anesthesia,
Vol. 7 No. 3 (2022),
11 July 2022
,
Page 153-159
https://doi.org/10.22037/jcma.v7i3.38005
Abstract
Background: Surgical trauma induces systemic inflammatory responses. We aimed to evaluate the influence of different analgesic models on postoperative pain and inflammatory markers modulation after major abdominal surgeries.
Materials and Methods: A total of 105 patients scheduled for elective abdominal colorectal surgeries were selected and randomly assigned to one of the three groups: Group-1 (GM) four micrograms/kg of IT morphine; Group-2 (GML) four microgram/kg of IT morphine plus 1.5 mg/kg intravenous Lidocaine loading dose and 2 mg/min saline infusion during the operation and the next 4 hours postoperative; Group-3 (G0, control group) no added drugs.
Results: Pain scored statistically significant lower figures in GML than the other two groups; p<0.001. Tumor Necrosis Factor-alpha serum levels showed a statistically significant difference between the three groups; P <0.001; GML showed the lowest level, followed by group GM and Group 0 (10.3±4.4 vs. 20±4.4 vs. 26±7.5). Transforming Growth Factor beta-1 demonstrated the highest levels measured in GML, high levels in GM, and the lowest level in G0; p<0.001, where mean serum levels were 43.1±12.5, 26 ±4.2, and 18.9±7.7, respectively. Opioid consumption was significantly lower in GML than other two groups; P<0.001.
Conclusion: Intraoperative and early postoperative intravenous Lidocaine infusion significantly improved the quality of postoperative analgesia. Optimizing analgesia in anesthetic management has a favorable effect on the pro and anti-inflammatory mediators.
Keywords: Abdominal surgeries, Postoperative pain, TNF-alpha and TGF-beta
- Keywords: Abdominal surgeries, Postoperative pain, TNF-alpha and TGF-beta
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References
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