RESEARCH ARTICLE


Serum IL-6 Level in Breast Cancer Surgery: Evaluating the Addition of Hydrocortisone to Two Anesthetic Regimens



Sherif Abdelhamid1, *, Ahmed Talha2, Salwa Hamdy3, Ashraf Arafat Abdelhalim4, Mohamed Elakany1
1 Department of Anesthesia, Medical Research Institute, Alexandria University, Alexandria, Egypt
2 Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt
3 Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt
4 Department of Anesthesia, Alexandria University, Alexandria, Egypt


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Creative Commons License
© 2015 Abdelhamid et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Anesthesia, Medical Research Institute, Alexandria University, Alexandria, Egypt; E-mail: dr_shereif@hotmail.com


Abstract

Background:

This study was purposed to compare in vitro the volumetric accuracy of a newly introduced automatic infusion controller, AutoClamp with that of other commonly used infusion devices.

Methods:

In this prospective, randomized, controlled trial, 124 ASA I-II, female patients, aged 30-50 years, undergoing conservative breast cancer surgery were randomly assigned to one of four equal groups receiving either standard general anesthesia and two doses of hydrocortisone (Group GH, n=31), thoracic paravertebral block and two doses of hydrocortisone (Group PH, n=31), standard general anesthesia with no hydrocortisone (Group G, n=31), or thoracic paravertebral block with no hydrocortisone (Group P, n=31). IL-6 was measured at three time points: before operation, 6 and 12 hours postoperatively. CRP and cortisol were measured preoperatively and 6 hours postoperatively.

Results:

On comparing group PH and GH, there was significant decrease in IL-6 level in group PH compared to group GH at 6 hour (122.1±21.2 vs 135.8±29.8pg/dl), but insignificant difference at 24 hours (107.9±21.6 vs 106.8±15.9pg/dl). CRP showed significant decrease in the postoperative reading in group PH compared to group GH (1.63±0.32 vs 1.91±0.43mg/l), and also group PH showed significant decrease compared to the control group P (1.63±0.32 vs 2.2±0.54).

Conclusion:

addition of hydrocortisone to general anesthesia or thoracic paravertebral block attenuated production of IL-6 and CRP levels significantly postoperatively compared to either anesthetic regimen alone, but not the serum cortisol level, highlighting its role in modifying the stress response to surgery. However, the effect was more pronounced when combined with thoracic paravertebral block.

Keywords: Anesthetic, breast, cancer, hydrocortisone, IL-6, regimens.