Neuroendocrine and Immune Responses to Surgery

Scholl, Rebecca; Bekker, Alex; Babu, Ramesh

doi:10.5580/2b9a

Cited by 13 publications

(2 citation statements)

References 31 publications

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“…CRP concentration increases within 4-6 hours after stimuli, such as incision, and reach its peak within 48 - 72 hours. Therefore, both IL-6 and CRP might represent stress response following surgery (2, 10).…”

Section: Introductionmentioning

confidence: 99%

Comparison of IL-6 and CRP Concentration Between Quadratus Lumborum and Epidural Blockade Among Living Kidney Donors: A Randomized Controlled Trial

et al. 2019

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Background An adequate anesthesia technique generates appropriate postoperative analgesic properties and decreases the patient’s stress response. This will lead to decreased morbidity and mortality associated with immunology disturbances, such as infection, prolonged wound healing, and sepsis. Objectives The aim of this study was to compare interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations, as the markers of the stress response, between continuous epidural and quadratus lumborum (QL) block as postoperative analgesia techniques among living kidney donors. Methods Sixty-two patients were randomly divided into two equal groups: continuous epidural and QL block. A group received bilateral QL block with 20 mL of bupivacaine 0.25% and the other received 6 mL/hour of bupivacaine 0.25% continuously via an epidural catheter. Prior to extubation, the QL block group received bilateral QL block with the same dose and the continuous epidural group was administered with 6 mL/hour of bupivacaine 0.125%. Blood samples were drawn to compare IL-6 and CRP concentrations after intubation (preoperatively), directly after surgery, 24 hours postoperatively, and 48 hours postoperatively. Postoperative pain was measured with the numerical rating scale (NRS). Morphine requirement and duration of catheter usage were also measured postoperatively. Side effects within 24 hours postoperatively were noted. Data were analyzed with independent t -test or Mann-Whitney test. Results No difference was observed between the groups in the plasma concentration of IL-6 either after surgery or 24 hours postoperatively (P = 0.785 and P = 0.361, respectively) although the mean IL-6 concentration 24 hours postoperatively was lower in the QL block group than in the continuous epidural group. CRP concentration was not significantly different between the groups either after surgery or 48 hours postoperatively (P = 0.805 and P = 0.636, respectively). Conclusions There was no significant difference in IL-6 and CRP concentrations between continuous epidural and QL block among living kidney donors. Both continuous epidural and QL block techniques showed comparable postoperative analgesic properties among living kidney donors undergoing laparoscopic nephrectomy.

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Section: Introductionmentioning

confidence: 99%

Comparison of IL-6 and CRP Concentration Between Quadratus Lumborum and Epidural Blockade Among Living Kidney Donors: A Randomized Controlled Trial

et al. 2019

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“…ERATS protocols are focused on attenuating the stress response and homeostatic disruptions that accompany major surgery [5,7]. Tissue damage from surgery activates a systemic inflammatory response, thereby causing changes in the neuroendocrine, metabolic, and immune systems [47]. This pro-inflammatory immune imbalance can lead to organ dysfunction and, ultimately, higher rates of postoperative complication.…”

Section: Postoperative Phase 61 Postoperative Pain Controlmentioning

confidence: 99%

Updates to Thoracic Procedures: Perioperative Care and Anesthetic Considerations

Pellechi¹,

DuBois²,

Harrison³

2023

Updates in Anesthesia - The Operating Room and Beyond

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Thoracic surgery is a rapidly evolving field, as is the perioperative and anesthetic care of patients undergoing major thoracic surgery. As surgical techniques continue to evolve, new guidelines are needed to help standardize patient care. To this end, Enhanced Recovery After Surgery (ERAS) protocols were created and have seen increasingly widespread adoption within the field of thoracic surgery. Despite their name, the scope of these protocols includes not only the postoperative period, but also helps guide care in the preoperative and intraoperative periods. Thus, ERAS pathways are relevant to both thoracic surgeons and anesthesiologists. This chapter aims to summarize current guidelines for managing patients undergoing thoracic surgery (from the preoperative period all the way through to postoperative care) by discussing recent updates within the field as well as some more well established tenets that remain relevant to the topic.

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