Effects of various anaesthetic techniques on haemodynamic stability and inflammatory cytokine (IL-6) level in patients undergoing breast cancer surgery

Abstract

Background: Different types of anesthesia have been shown to influence the balance of inflammatory cytokines to varying degrees, Anesthesia may modulate cancer growth and metastasis through directly influencing biological behaviors of cancer cells, or improving tumor microenvironment. Due to this we aim to evaluate the effects multimodal anaesthesia technique on level of IL-6 inflammatory cytokines in breast carcinoma surgery. Materials and Methods: The present study was conducted in the Department of Anesthesiology of the MGM College, Navi Mumbai. For the study, we included patients with ASA grade I and II, age 18 to 65 years. Informed consent was obtained from all the patients. Patients were grouped randomly into three groups (n= 15 in each group). Group I: Received paracetamol as premedication 10 mg/kg and fentanyl at the time of induction 2 μg/kg and continued as normal general anaesthesia. Group II: Received paracetamol at 10 mg/kg and dexmedetomidine 0.5μg/kg as premedication and fentanyl at 2 μg/kg at the time of induction and continued as normal general anaesthesia. Group III: Received paracetamol 10 mg/kg and dexmedetomidine 0.5 μg/kg at the time of premedication and fentanyl at 2 μg/kg at time of induction and paravertebral block with levobupivacaine and continued as normal general anaesthesia. Results: We observed that the mean age in group 1, group 2 and group 3 was 36.38 years, 39.25 years and 41.23 years, respectively. The mean weight of group 1, group 2 and group 3 patients was 61.38, 57.29 and 58.21 kg respectively. The duration of surgery was 112.39, 118.22 and 117.29 min, respectively for Group 1, 2 and 3.We observed that IL-6 levels decreased in all the groups. The decrease in IL-6 level postoperative was statistically significant for Group 3. The mean heart rate, at base line, induction time, intubation time and postoperative were not statistically difference in between all three groups. Conclusion: Multimodal approach is a better anesthetic technique in terms of hemodynamic stability with decreased levels of IL-6 inflammatory cytokines.