Background: Immune balance is mandatory for proper postoperative (PO) courses
and wound healing. Cesarean section is the commonest surgical procedure for
females. The choice of anesthetic procedure may affect the mother and fetal
outcomes.
Objectives: Evaluation of the impact of general (GA) versus spinal anesthesia (SA)
on parturient' cytokines' serum levels.
Patients and methods: 73 and 59 parturients received GA and SA, respectively. Fetal
APGAR scoring was determined at 1-min & 5-min PO. PO pain severity was
evaluated using the numeric rating scale and the duration of analgesia was calculated.
Blood samples (S1, S2, S3) were obtained for ELISA estimation of serum interleukins
and tumor necrosis factor-α (TNF-α). The study outcome is the effect of the anesthetic
procedure on serum cytokines levels.
Results: Cytokines' levels were significantly higher in S2 and S3 than in S1 samples
of all parturients with significantly higher levels in samples of GA patients.
Percentages of change in serum cytokines' levels were higher with GA than with SA.
Receiver operating characteristic (ROC) curve defined serum levels of TNF-α as the
most cytokine affected by the anesthetic procedure. APGAR scores were significantly
higher at 1-min and the duration of PO analgesia was significantly longer with SA.
Conclusion: SA can lessen the surgery-induced release of inflammatory cytokines,
while GA augments this effect. Moreover, neonatal and maternal outcomes were
superior with SA than with GA. |
