Effects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study

Esam Hamed; Nagla El-Melegy; Samir Ammar; rasha hamed

doi:10.22037/jcma.v7i3.38005

Journal of Cellular & Molecular Anesthesia

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https://doi.org/10.22037/jcma.v7i3.38005

Effects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study

Author(s):

Esam Hamed^1,*,

Nagla El-Melegy²,

Samir Ammar³,

rasha hamed⁴

1Anesthesiology, ICU and Pain Management Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

2Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt

3Surgery Department, Faculty of Medicine, Assiut University, Assiut, Egypt

4Assiut University

Journal of Cellular & Molecular Anesthesia:Vol. 7, issue 3; e150200

Published online:May 13, 2022

Article type:Original Articles

How to Cite:Esam HamedNagla El-MelegySamir Ammarrasha hamedEffects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study.J Cell Mol Anesth.7(3):e150200.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

Keywords: Abdominal surgeries

Postoperative pain

TNF-alpha and TGF-beta

References

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References are in the PDF file of the article.

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Author(s):

Esam Hamed:[PubMed][Scholar]
Nagla El-Melegy:[PubMed][Scholar]
Samir Ammar:[PubMed][Scholar]
rasha hamed:[PubMed][Scholar]