Effects of anaesthesia based on high versus low doses of opioids on the cytokine and acute-phase protein responses in patients undergoing cardiac surgery

Acta Anaesthesiologica Scandinavica
V Brix-ChristensenG B Stefano

Abstract

Cardiac surgery with cardiopulmonary bypass (CPB) evokes a systemic inflammatory response involving the proinflammatory cytokines tumor necrosis factor-alpha (TNFalpha), interleukin (IL)-1, IL-6, IL-8 and anti-inflammatory cytokines such as IL-10. Like IL-10, opioids downregulate the immune responses in vivo and in vitro, including the activity of the cytokine-producing monocytes and granulocytes. The proinflammatory cytokines are potent inducers of the hepatic acute-phase protein synthesis. The aim of the present study was to investigate if choice of anaesthesia, based on high-dose opioids (fentanyl) versus low-dose opioids influenced the release of IL-6, IL-8, and IL-10. Secondly, it was investigated whether serum amyloid P-component (SAP) is an acute-phase protein in man such as C-reactive protein (CRP), with which it is physically and structurally related. Sixteen patients submitted to elective coronary artery bypass grafting (CABG) surgery were randomized to either low-dose opioid anaesthesia consisting of thoracic epidural analgesia combined with inhalational anaesthesia (group I) or high-dose fentanyl anaesthesia (group II). From each patient 18 blood samples were taken perioperatively. Cytokine analyses were performed w...Continue Reading

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Citations

Feb 26, 1998·International Journal of Cardiology·V Brix-ChristensenG B Stefano
Aug 18, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R LangoM Narkiewicz
Mar 4, 2006·European Journal of Anaesthesiology·H GuggenbergerH K Eltzschig
Nov 7, 2000·Acta Anaesthesiologica Scandinavica·V Brix-ChristensenG B Stefano
Jun 26, 2001·Acta Anaesthesiologica Scandinavica·V Brix-Christensen
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