Journal of Cellular and Molecular Anesthesia
Year:2018 | Volume:3 | Issue:3|Papers Count:7

Since the first laparoscopic surgery on human in 1980s, the potential for manipulating the inflammatory and metabolic response to surgical trauma has been put into debate (1-5). Many physicians suggest that laparoscopic interventions are better called as “ minimally invasive surgeries” , as in actuality they pose less “ invasion” to the tissue, which is analogous to diminished inflammatory harmful mediators (4, 6, 7)....

Background: The purpose of this study is to investigate the impact of different anesthetic techniques on the release of cytokines interleukin IL-6, IL-10 and tumor necrosis factor (TNF)-α in preeclampsia patients who undergo cesarean section. Materials and Methods: In the study 40 patients were enrolled with preeclampsia undergoing cesarean section, allocated into two equal groups to receive either general anesthesia (n = 20) or spinal anesthesia (n = 20). Non-invasive hemodynamic monitoring was used. Serum levels of IL-6, IL-10 and TNF-α were measured before and at the end of surgery. Results: There was no significant rise in serum levels of TNF-α in general anesthesia while IL-6 and IL-10 serum levels increased significantly. Also, compared with patients anaesthetized with general anesthesia patients who received regional anesthesia notably had lower levels of IL-6 and IL-10 after surgery (p < 0. 05). Conclusion: Spinal anesthesia causes significant difference in post-operation IL-6 and IL-10 serum levels in preeclampsia patients undergoing cesarean section. Nevertheless, neither general nor spinal anesthesia made such effect on serum level of TNF-α . Further studies with higher sample size and comparing preeclamptic patients to healthy mothers undergoing cesarean section are required.

Background: A number of preventive or therapeutic strategies have been proposed to compensate for the inflammatory process during adult cardiac surgeries; none has been considered definitive. 1, 25 (OH)2 vitamin D3 is a type of physiologic hormones with immunomodulatory effects. This study assessed the effect of oral vitamin D on serum levels of interleukin-1 (IL-1), IL-6 and tumor necrosis factor alpha (TNF-α ) in adult coronary artery bypass grafting (CABG). Materials and methods: In a double blind placebo controlled clinical trial, with a sample size of 80 patients, randomly assigned in either the placebo group (including 40 patients; placebo pills) or the intervention group (i. e. 40 patients; vitamin D pearls), CABG surgery with cardiopulmonary bypass was performed. Serum cytokines (IL-1, IL-6, and TNF-α ) were evaluated preoperatively and during the first postoperative day. Results: Serum TNF-α level was similar in the two groups; however, postoperative levels of IL-1 and IL-6 were significantly lower in vitamin D group. Conclusion: The current study demonstrated that oral vitamin D supplements could augment immunomodulatory effects in adult patients undergoing cardiac surgical procedures (mainly CABG).

Background: Interleukin-6 (IL-6) plays an important role in inflammatory. Epidural anesthesia is an appropriate method for controlling pain in lower limb surgeries. The aim of this study was to evaluate the effect of Dexmedetomidine and Lidocaine in the epidural injection by measuring IL-6 plasma levels. Materials and Methods: Fifty-two patients with lower limb fractures in two groups receiving Dexmedetomidine doses and controls for the quality of epidural anesthesia and IL-6 index. After explaining the design and obtaining informed written consent, patients were randomly divided into two groups. After 4– 6 minutes of administering the test dose, patients in group RC received 5 ml of 1. 5% Lidocaine solution via epidural catheter. Patients in group RD were administered 15 ml solution of 1. 5% ropivacaine and 0. 6 μ g/kg of Dexmedetomidine. The levels of IL-6 were evaluated before surgery and 6 hours after surgery. Results: The two groups did not show a significant difference in age and level of interleukin prior to the operation. There was a significant difference in the second injection time and total drug volume between the control and intervention groups. Dexmedetomidine reduced the volume of total drug needed and increased the time interval from the first injection to the second one (p <0. 001). There was also lower levels of interleukin 6 in the Dexmedetomidine group at the 6th hour after the operation. Conclusion: Dexmedetomidine does not only reduce the need for patients on the amount and frequency of analgesic drugs, but also reduces stress and cellular damage.

Background: Liver dysfunction is a rare complication with high mortality and morbidity rate in coronary artery bypass grafting (CABG) surgery. Pulsatile blood flow probably maintains liver function during cardiopulmonary bypass (CPB). Methods: In this randomized clinical trial study, 68 patients who underwent CABG surgery were divided into two groups: pulsatile and non-pulsatile groups. We transferred continuous blood flow to pulsatile blood flow during proximal graft by using cardiac contraction. Results: There was no significant difference in Alanine transaminase (ALT) and alkaline phosphatase (ALP) values at variable times between the groups. In addition, the procedure of ALT and ALP in the case and control groups was not significantly different in three days. There was no significant difference between AST values at variable times in two groups. However, the trend of AST in the case group was significantly increased while it was not significantly different in the control group during the next three postoperative days. Conclusion: It seems that hemodynamic stability is more important than type of blood flow in maintaining liver function.

Background: The currently used antiemetic drugs are not effective in all post-operative patients due to multifactorial origin of nausea and vomiting. Therefore, the present study was designed to evaluate the preventive effect of paracetamol on postoperative nausea and vomiting (PONV) in comparison with dexamethasone in patients undergoing elective laparoscopic cholecystectomy. Materials and Methods: in this double-blinded clinical trial 105 patients were selected using a random sampling method; they were American standards association (ASA) class I and II, 18-75 years and candidate for laparoscopic cholecystectomy; randomly assigned into three groups: Paracetamol, Dexamethasone, and control. They were anesthetized using the same method, using sodium thiopental, Fentanyl, Atracurium, and Lidocaine. Anesthesia was maintained with oxygen, Isoflurane and Morphine. They also received 6 mL/kg/h ringer lactate. Patients data were recorded and analyzed. Results: The mean severity of nausea and vomiting in the recovery room at minutes 30, 45, and 60 had a significant difference between the groups (p<0. 05). The satisfaction score at minutes 45 and 60 had a significant difference between the groups (p<0. 05). However, the mean scores of satisfaction of patients at 15 and 30 minutes were almost the same and no significant difference between the three groups was reported (p>0. 05). Conclusion: The severity of nausea and vomiting was low in the Paracetamol group and Paracetamol was more effective than Dexamethasone in terms of reducing the rate of nausea and vomiting.

Due to the development of surgical techniques for controlling the conditions of patients, we are still faced with many conditions and risks in the management of patients' health during and after surgery. Hence, the creation of new methods, access to medicines and things that increase the quality of management and improve patient control conditions are on the agenda of many research teams around the world. Antioxidant substances and their effects on the control of free radicals (as one of the destructive factors on the health of patients undergoing surgery) is one of the research cases that has attracted many researchers in recent years. Cardiac surgery and cardiac anesthesia are among the most challenging types of surgeries. Control and management of patient conditions during this type of surgery is one of the most important challenges of anesthesiology team. This study tries to investigate the importance of antioxidants in controlling conditions and improving the status of patients undergoing cardiac surgery.