Assessment of Inflammatory Markers in the Epidural Infusion of Bupivacaine-Fentanyl Compared to Morphine Bolus Injection in Gastrointestinal Cancer Surgeries

Abstract

BackgroundTissue damage, pain, and anesthesia cause immunological alterations and metabolic and endocrine reactions in patients both perioperatively and postoperatively. [1][2][3] These responses related to severity can have differing consequences, varying from the patient's susceptibility to infection, wound healing, systemic inflammatory response syndrome, and organ malfunction or failure. [4][5][6][7] In addition to inflammation, increased inflammatory markers, and pain, following surgery, high doses of narcotics and non-opioid analgesics may be required. 8,9 However, controversies remain about the effects of the types and amounts of anesthesia and postoperative analgesia on immunological reactions to major surgical procedures. [10][11][12] Gastrointestinal surgery produces inflammatory reactions and pain for patients. The administration of highly safe analgesia in surgery is essential for reducing pain and improving inflammatory reactions. Inappropriate pain management may result in increased morbidity and, consequently, increased hospitalization and higher medical costs. 8 Epidural analgesia is commonly used as an effective and safe strategy for pain relief in surgeries. 8,9 It can reduce pain and effect earlier intubation times, better hemodynamics, and fewer respiratory complications. 8 ObjectivesThe current study compared inflammatory markers and pain in epidural infusion of bupivacaine-fentanyl and morphine bolus injection in gastrointestinal cancer surgeries.