Preemptive analgesia with epidural bupivacaine plus fentanyl in gynaecological surgery—effects on serum interleukin-6 concentrations

Abstract

Abstract Purpose: The aim of this study was to evaluate preemptive analgesia and its influence on interleukin-6 (IL-6) levels. Methods: Thirty patients scheduled for hysterectomy were randomised in two groups to receive 13 ml bupivacaine 0.25% plus fentanyl (100 μg) before incision and 15 ml of saline after incision (group I, GI), or 15 ml of saline before incision and 13 ml bupivacaine 0.25% plus fentanyl (100 μg) after incision (group II, GII). General anaesthesia was performed using propofol/pancuronium/O2/isoflurane. Postoperative analgesia consisted of epidural bolus doses of 4 ml bupivacaine 0.25% plus fentanyl (50 μg) or dipyrone i.v. on demand. Pain was assessed by visual analogue scale (VAS). IL-6 levels were quantified during the study. Results: Patients in group I had significantly less pain only at arrival in recovery room. The requirements for rescue analgesia were similar in both groups and there were no significant differences in IL-6 concentrations. Conclusions: This study showed no preemptive effect of epidural fentanyl plus bupivacaine on postoperative pain and stress response as measured by IL-6 concentrations.