Preoperative administration of corticosteroids in thoracic anesthesiology

Abstract

Annotation. One lung ventilation (OLV) is one of the most difficult intraoperative methods of respiratory support for anesthesiologists. OLV should provide the most comfortable surgical field, maintaining proper gas exchange and minimizing damage to both lungs. This anesthetic procedure has a significant inflammatory response, so using perioperative corticosteroid therapy to suppress inflammatory mediators is recommended as an approach to improving prognosis. Therefore, the aim of this study was to determine how the preoperative administration of methylprednisolone affects the systemic proinflammatory response of cytokines during thoracic surgery. The analysis was performed for 80 patients who underwent surgeries in the thoraco-abdominal department of the Shalimov National Institute of Surgery and Transplantology. Patients were divided into 2 groups (study – 40 patients who were administered methylprednisolone 10 mg / kg intravenously during induction of anesthesia and control – 40 patients without methylprednisolone). Before surgery and in the postoperative period on days 1, 3 and 5, the surface phenotype of peripheral blood lymphocytes and the expression of IL-6 by monocytes were determined by flow cytofluorometry. The author's MedStat package was used for statistical analysis (Lyakh Yu.E., Guryanov V.G., 2004–2012). Postoperative indicators of IL-6 monocyte expression in the blood of patients administered methylprednisolone were significantly lower on the 1st and 3rd postoperative day (p<0.001). Thus, preoperative administration of methylprednisolone reduces the release of pro-inflammatory cytokines and improves the condition of patients after thoracic surgery. We consider it expedient to conduct further research on the administration of methylprednisolone for several days in the postoperative period.