Impact of anesthesia method on cortisol and interleukin-6 concentration changes during and after laparoscopic colorectal surgery
Keywords: laparoscopic colorectal surgery, cortisol, interleukin-6, epidural analgesia
AbstractResults and discussion. There were statistically significant differences be tween the groups in pain score after surgery (p < 0.001) and 24 hours later (p < 0.000) and in bowel motility after anaesthesia (p < 0.001). In EA group bowel motility was observed in 96.2% of patients after surgery and lasted more than 24 hours despite of infusion of local anesthetic mixture with morphine. In the GA group only in 55.6% of cases bowel motility was observed after anaesthesia. No differencies in bowel motility was determined between the groups 24 hours later. We determined statistically significant differences in cortisol value after surgery comparing EA and GA groups (p < 0.003) and also between three groups, despite the duration of anaesthesia statistically signi ficant longer in the EA group. The highest cortisol value was determined in the conversion group. The interleukin-6 concentration diferencies were found sig nificantly relevant comparing the EA group with CG and also comparing the GA group with CG (p < 0.000). Studying complications associated with intestinal anastomosis permeability using non-parametrical test some asso ciation between interleukin-6 concentration after 24 hours and anastomosis problems (p < 0.039) was determined. No diferencies in CRP findings between EA and GA groups during the 6-day postoperative period were determined. Conclusions. Combined general anesthesia with epidural analgesia war rant better pain control after LCS and attenuate stress response reducing se cretion of cortisol and interleukine-6.