Elevated plasma levels of interleukin-6, interleukin-8, and granulocyte colony-stimulating factor during and after major abdominal surgery

doi:10.1016/S0952-8180(97)00006-8

Journal of Clinical Anesthesia

Volume 9, Issue 4, June 1997, Pages 293-298

https://doi.org/10.1016/S0952-8180(97)00006-8 Get rights and content

Abstract

Study Objective: To evaluate the influence of major abdominal surgery on the plasma levels of inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8) and granulocyte colony-stimulating factor (G-CSF).

Design: Prospective study.

Setting: University hospital.

Patients: 10 ASA physical status I and II patients undergoing upper abdominal surgery.

Interventions: All patients received combined general-epidural anesthesia with isoflurane and nitrous oxide, after insertion of an epidural catheter at T₇-T₉ dosed with 1.5% lidocaine.

Measurements and Main Results: Plasma cytokine (IL-6, IL-8, G-CSF) levels were determined with an enzyme-linked immunosorbent assay (ELISA) at pre-anesthesia, 0, 2, and 4 hours during surgery, and at the end of surgery, followed by sampling on the morning of postoperative days 1 (POD1) and 3 (POD3). Plasma cortisol levels were also determined. The plasma levels of IL-6 increased gradually after skin incision and reached the maximal value at the end of surgery (p < 0.001). IL-8 levels also increased from the baseline value to their maximum at the end of surgery (p < 0.05). G-CSF levels were elevated from the pre-anesthesia value to their maximum by the end of operation (p < 0.005). Plasma cortisol levels were increased after skin incision (p < 0.001). Postoperative cytokine levels correlated significantly with each other (r = 0.68, p < 0.05 for IL-6 vs. IL-8; r = 0.81, p < 0.005 for IL-6 vs. G-CSF; and r = 0.84, p < 0.005 for IL-8 vs. G-CSF). Postoperative IL-6 levels and intraoperative blood loss correlated significantly (r = 0.64, p < 0.05).

Conclusions: These results suggest that major upper abdominal surgery stimulates the release of inflammatory cytokines presumably from the operation site. Further study is warranted to evaluate the modulation of inflammatory responses in the perioperative period.

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^∗: Assistant Professor.

^†: Postgraduate Student.

^§: Associate Professor.

^∥: Professor and Chairman.

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Original contributionElevated plasma levels of interleukin-6, interleukin-8, and granulocyte colony-stimulating factor during and after major abdominal surgery

Abstract

Br J Anaesth

Lancet

Cytokine

Metabolism

Br J Anaesth

Br J Anaesth

Chest

Metabolic response to sepsis and trauma

Br J Surg

Anticytokine strategies in the treatment of the systemic inflammatory response syndrome

JAMA

Responses of plasma adrenocorticotropic hormone, cortisol, and cytokines during and after upper abdominal surgery

Anesthesiology

High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with adult respiratory distress syndrome after trauma, shock, or sepsis

Am Rev Respir Dis

In vivo stimulation of granulopoiesis by recombinant human granulocyte colony-stimulating factor

Association between elevated plasma granulocyte colony-stimulating factor and the degree of surgical stress in patients undergoing gastrointestinal surgery

Surg Today

Corticosteroids differentially regulate secretion of IL-6, IL-8, and G-CSF by a human bronchial epithelial cell line

Am J Physiol

Interleukin-8 induces neutrophil transendothelial migration

Immunology

Original contribution
Elevated plasma levels of interleukin-6, interleukin-8, and granulocyte colony-stimulating factor during and after major abdominal surgery