Comparative Study between General Anesthesia versus General Anesthesia Combined with Thoracic Epidural Analgesia on Cytokine Response in Laparoscopic Cholecystectomy Patients

• 作者: Ahmed Elsaied Abd-elrahman Aly Amir Abouzkry Elsayed Gamal Hendawy Rezk Shams Nagwa Mohammed Gamal EI-deen Wafaa Salah Mohammed
• 来源期刊: 麻醉学期刊(英文)
• 学科: 医学
• 关键词: General Anesthesia Thoracic Epidural Analgesia CYTOKINE Laparoscopic Cholecystectomy
• 年，卷（期）: 2020,（6）
• 页码范围: 247-262
• 页数: 16页
• 分类号: R65

摘要

<b><span>Background and Objectives: </span></b><span>The main benefits of laparoscopic surgery in comparison to open surgery involve the rapid discharge from recovery room, decreased postoperative hospital stays, reduced postoperative discomfort, easier getting back to work and faster return to ordinary daily life as well as cosmetic surgical wounds. The anesthesia type has an essential role in attenuation of the surgical stress and achievement of these advantages. We aimed to determine the outcome of giving general anesthesia in conjunction with thoracic epidural analgesia (TEA) compared to general anesthesia alone on stress response to surgery and anesthesia by investigating cytokine reaction (interleukin 6 and 8 levels), hemodynamic changes (BP, HR, RR, SPO2), and Visual Analogue Scale (VAS) scores postoperatively in patients subjected for laparoscopic cholecystectomy. </span><b><span>Methods: </span></b><span>This study included 40 patients aged 20</span><span> </span><span>- 60 years old with American Society of Anesthesiologists physical status (ASA) I and II. They were planned for laparoscopic cholecystectomy at Aswan University Hospital from April 2017 to March 2018. They were randomly allocated into two groups.</span><b><span> </span></b><span>Group A (n. 20) received general anesthesia only and Group B (n. 20) received general anesthesia in conjunction with thoracic epidural analgesia using fentanyl and bupivacaine in the epidural catheter. Chi-square was applied to differentiate categorical variables, whereas comparison between continuous variables was done by using t-test. Two-tailed p < 0.05 was estimated as statistically signi</span><span>fi</span><span>cant. </span><b><span>Results:</span></b><span> As regards IL-6 and IL-8 post-operative there is significant difference (p < 0.05) between two groups during 2</span>^{<span style="vertical-align:super;">nd</span>}<span> and 4</span>^{<span style="vertical-align:super;">th</span>}<span> hr and 24</span><sup><span style="vertical-a