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Saudi J Anaesth. 2013 Oct;7(4):373-7. doi: 10.4103/1658-354X.121043.

Paravertebral block can attenuate cytokine response when it replaces general anesthesia for cancer breast surgeries.

Author information

1
Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

CONTEXT:

Cytokine release is a well-known response to surgery especially when it is linked to cancer. Paravertebral block (PVB) is the suitable regional anesthesia for breast surgery.

AIM:

We tested the effect of replacing general anesthesia (GA) with PVB on cytokine response during and after surgeries for cancer breast.

SETTINGS AND DESIGN:

Controlled randomized study.

METHODS:

Forty cancer breast patients were divided in two groups; Group I received PVB and Group II received GA during performance of unilateral breast surgery without axillary clearance. Plasma concentrations of interleukin (IL)-6, IL-10, IL-12 and interferon-γ (IFN-γ) were measured and IL-10/IFN-γ were estimated in the following points; before starting PVB in Group I or induction of GA in Group II (Sample A), before skin incision (Sample B), at the end of procedure before shifting out of operating room (Sample C), 4-h post-operatively (Sample D) and 24-h post-operatively (Sample E).

STATISTICAL ANALYSIS:

unpaired Student t-test.

RESULTS:

IL-6 increased progressively in both groups with statistically significant lower levels in samples C and D in Group I. IL-10 levels showed progressive increasing in both groups without differences between groups. IL-12 showed progressive decrease in both groups with statistically significant higher levels in samples C and D in Group I. IFN-levels showed significantly higher levels in samples C and D in Group I. IL-10/IFN-γ ratio was significantly lower in Group II in samples C and D.

CONCLUSION:

Replacing GA with PVB can attenuate cytokines response to cancer breast surgeries.

KEYWORDS:

Cancer breast; interleukins; paravertebral block

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