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

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 ۱۰۵ patients scheduled for elective abdominal colorectal surgeries were selected and randomly assigned to one of the three groups: Group-۱ (GM) four micrograms/kg of IT morphine; Group-۲ (GML) four microgram/kg of IT morphine plus ۱.۵ mg/kg intravenous Lidocaine loading dose and ۲ mg/min saline infusion during the operation and the next ۴ hours postoperative; Group-۳ (G۰, control group) no added drugs. Results: Pain scored statistically significant lower figures in GML than the other two groups; p<۰.۰۰۱. Tumor Necrosis Factor-alpha serum levels showed a statistically significant difference between the three groups; P <۰.۰۰۱; GML showed the lowest level, followed by group GM and Group ۰ (۱۰.۳±۴.۴ vs. ۲۰±۴.۴ vs. ۲۶±۷.۵). Transforming Growth Factor beta-۱ demonstrated the highest levels measured in GML, high levels in GM, and the lowest level in G۰; p<۰.۰۰۱, where mean serum levels were ۴۳.۱±۱۲.۵, ۲۶ ±۴.۲, and ۱۸.۹±۷.۷, respectively. Opioid consumption was significantly lower in GML than other two groups; P<۰.۰۰۱. 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