Effects of Anesthesia Technics on Certain Cytokines for Patients Undergoing Surgery: A Clinical Diagnostic Study

Main Article Content

Kamal Jalal Rashid
Safa Bakir Karim
Muhammed Babakir-Mina


Background: Change of circulating cytokines level were normally low and may be uncleared within 30 - 60 minutes during anesthesia. The concentration of most of cytokines increases at 2 - 4 hours after operation.

Materials and Methods: The prospective clinical diagnostic study was performed on 100 patients undergoing surgery. First blood samples were collected from the patients before induction and second samples were collected 6 hours after operation. Cytokine serum level tests were performed for all samples to diagnose the level of cytokine cell interleukin -6 (IL-6), interleukin -10 (IL-10), tumor necrosis factor -alpha (TNF-α) and interferon - gamma (INF-γ) pre- and post-operative.

Results: Most of patients operated with general anesthesia, The mean level of serum IL-6, IL-10 and TNF-α slightly increased after operation and significant differences were shown in patients whom under surgery for 2-3 hours (p<0.05) but significant changes of IFN-γ were higher (p<0.001). Significant elevations were seen after operation during general and mixed (spinal + general) anesthesia for IL-10 and TNF-α and IFN-γ. Post operative changes in mean serum level for IFN-γ was higher than the changes for IL-6, IL-10 and TNF-α and clearly significant were shown for patients who operated under GA or mix (SA+GA). Highly significant mean differences ratio (Before : After) anesthesia and surgery were shown for IL-10 during GA and SA+GA and INF-γ p<0.001.

Conclusion: General anesthesia significantly increases the serum level of IL-10, TNF-α and INF-γ rather than spinal anesthesia after operation. Therefore, spinal anesthesia and short-term operations not considerable and changes in the immune response for patients undergoing surgery   

Article Details

How to Cite
Jalal Rashid , K. ., Bakir Karim, S. ., & Babakir-Mina, M. . (2023). Effects of Anesthesia Technics on Certain Cytokines for Patients Undergoing Surgery: A Clinical Diagnostic Study. Journal of Coastal Life Medicine, 11(1), 383–394. Retrieved from https://www.jclmm.com/index.php/journal/article/view/350


Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL. Miller's anesthesia e-book: Elsevier Health Sciences; 2014.

Hardman JG, Hopkins PM, Struys MMF. Oxford textbook of anaesthesia: Oxford University Press; 2017.

Serpell M. Pencil point spinal needles and neurological damage. British journal of anaesthesia. 2002;89(5):800-1.

Hadade A. The impact of anesthesia and surgery on plasma cytokine production. Biotechnol Mol Biol Nanomed. 2014;2(1).

Scholl R, Bekker A, Babu R. Neuroendocrine and immune responses to surgery. Internet J Anesthesiol. 2012;30(3).

Amin OA, Salah HE. The effect of general or spinal anaesthesia on pro-and anti-inflammatory intracellular cytokines in patients undergoing appendicectomy using flowcytometric method. Egyptian Journal of Anaesthesia. 2011;27(2):121-5.

Hsing C-H, Wang J-J. Clinical implication of perioperative inflammatory cytokine alteration. Acta Anaesthesiologica Taiwanica. 2015;53(1):23-8.

Helmy S, Wahby M, El‐Nawaway M. The effect of anaesthesia and surgery on plasma cytokine production. Anaesthesia. 1999;54(8):733-8.

Desborough J. The stress response to trauma and surgery. British journal of anaesthesia. 2000;85(1):109-17.

Sheeran P, Hall G. Cytokines in anaesthesia. British journal of anaesthesia. 1997;78(2):201-19.

Dang Y, Shi X, Xu W, Zuo M. The effect of anesthesia on the immune system in colorectal cancer patients. Canadian Journal of Gastroenterology and Hepatology. 2018;2018.

Qiu X, Zhang L, Tong Y, Qu Y, Wang H, Mu D. Interleukin-6 for early diagnosis of neonatal sepsis with premature rupture of the membranes: a meta-analysis. Medicine. 2018;97(47).

Weis F, Beiras-Fernandez A, Schelling G, Briegel J, Lang P, Hauer D, et al. Stress doses of hydrocortisone in high-risk patients undergoing cardiac surgery: effects on interleukin-6 to interleukin-10 ratio and early outcome. Critical care medicine. 2009;37(5):1685-90.

Simsek E, Karapinar K, Bugra O, Ulus AT, Sarigul A. Effects of albumin and synthetic polypeptide-coated oxygenators on IL-1, IL-2, IL-6, and IL-10 in open heart surgery. Asian journal of surgery. 2014;37(2):93-9.

Elenkov IJ, Chrousos GP. Stress hormones, proinflammatory and antiinflammatory cytokines, and autoimmunity. Annals of the New York Academy of Sciences. 2002;966(1):290-303.

Kennedy B, Hall G. Neuroendocrine and inflammatory aspects of surgery: do they affect outcome? Acta Anaesthesiologica Belgica. 1999;50(4):205-9.

Amodeo G, Bugada D, Franchi S, Moschetti G, Grimaldi S, Panerai A, et al. Immune function after major surgical interventions: the effect of postoperative pain treatment. Journal of pain research. 2018;11:1297.

Takala R, Soukka H, Salo M, Kirvelä O, Kääpä P, Aantaa R. Gene expression of pulmonary cytokines after sevoflurane or thiopentone anaesthesia in pigs. Acta anaesthesiologica scandinavica. 2006;50(2):163-7.

Altun MA, Ozaydin A, Arkan H, Demiryas S, Akbas F, Bahtiyar N, et al. Anesthesia may alter mRNA expression of certain wound healing-associated genes in dermal wound environment of the rats. Molecular biology reports. 2019;46(3):2819-27.

Kim H-J, Roychoudhury P, Lohia S, Kim J-S, Kim H-T, Ro Y-J, et al. Comparison of general and spinal anaesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty: A propensity score matching analysis. Medicina. 2021;57(11):1250.

O’Dwyer MJ, Owen HC, Torrance HD. The perioperative immune response. Current opinion in critical care. 2015;21(4):336-42.

Mahdy A, Galley HF, Abdel‐Wahed M, El‐Korny K, Sheta S, Webster NR. Differential modulation of interleukin‐6 and interleukin‐10 by diclofenac in patients undergoing major surgery. British journal of anaesthesia. 2002;88(6):797-802.

Vosoughian M, Dahi-Taleghani M, Moshari M, Rajaei S, Rajabi S, Taheri F. The effect of spinal and general anesthesia on cytokine serum levels following cesarean section in preeclampsia. Journal of Cellular and Molecular Anesthesia. 2018;3(3):89-97.

Weledji E. Cytokines and the metabolic response to surgery. J Clin Cell Immunol. 2014;5(2):1-5.

Schneemilch CE, Ittenson A, Ansorge S, Hachenberg T, Bank U. Effect of 2 anesthetic techniques on the postoperative proinflammatory and anti-inflammatory cytokine response and cellular immune function to minor surgery. Journal of clinical anesthesia. 2005;17(7):517-27.

Zhang J, Zhang W, Li B. The effect of epidural anesthesia with different concentrations of ropivacaine on sevoflurane requirements. Anesth Analg. 2007;104(4):984-6. doi: 10.1213/01.ane.0000258765.16164.27. PubMed PMID: 17377119.

Farrar M, Hall G. Neuroendocrine and inflammatory aspects of surgery: do they affect outcome? European Journal of Anaesthesiology| EJA. 1998;15(6):736-9.

Graham EA. The influence of ether and ether anesthesia on bacteriolysis, agglutination, and phagocytosis. The Journal of infectious diseases. 1911:147-75.

Hassanshahi G, Hadavi M, Jafarzadeh A, Rezaeian M, Vazirinejad R, Sarkoohi A, et al. Anesthesia technique and serum cytokine concentrations in the elective cesarean section. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences. 2021;26.