Article citationsMore>>

Vicente, D., Patino, M. Marcus, R., Lillmoe, H., Limani, P., Newhook, T., Lee, A., Tzeng, C., Segraves-Chun, Y., Tweardy, D., Gottumukkala, V., Jean-Nicolas, V., Aloia, T. and Cata, J.P. (2019) Impact of Epidural Analgesia on the Systemic Biomarker Response after Hepatic Resection. Oncotarget, 10, 584-594.
https://doi.org/10.18632/oncotarget.26549

has been cited by the following article:

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

  AUTHORS: Amir Abouzkry Elsayed, Nagwa Mohammed Gamal EI-deen, Gamal Hendawy Rezk Shams, Ahmed Elsaied Abd-elrahman Aly, Wafaa Salah Mohammed

  KEYWORDS: General Anesthesia, Thoracic Epidural Analgesia, Cytokine, Laparoscopic Cholecystectomy

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.10 No.6, June 18, 2020

  ABSTRACT: Background and Objectives: 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. Methods: This study included 40 patients aged 20- 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.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 ficant. Results:As regards IL-6 and IL-8 post-operative there is significant difference (p ndand 4thhr and 24thhr postoperative, with significantly increased postoperative levels of IL-6 and IL-8 in comparison to their preoperative baseline values. The largest increase in IL6 & IL8 levels was in group A (GA group). VAS score showed significant lower values in TEA group in comparison to GA group. No significant difference between groups as regard intraoperative and postoperative hemodynamic changes. Conclusion: Regional techniquesincluding TEA attenuate and decrease cytokine reaction secondary to surgery which decreasesinflammatory process and improvespatient outcome and reducespain score postoperatively.