Effects of Different Pneumoperitoneum Pressures on IL-1, IL-6, and TNF-α
10.3969/j.issn.1009-6604.2014.11.017
- VernacularTitle:腹腔镜手术不同气腹压力对 IL-1β，IL-6和TNF-α的影响
- Author:
Tao XIE
;
Jinmiao XIAO
- Publication Type:Journal Article
- Keywords:
Laparosopic surgery;
Pneumoperitoneum;
Cytokine;
Stress reaction
- From:
Chinese Journal of Minimally Invasive Surgery
2014;(11):1028-1032,1054
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effects of different pressures of carbon dioxide pneumoperitoneum under laparoscopic surgery on IL-1β, IL-6, and TNF-α. Methods Ninety patients with ASA Ⅰor Ⅱwho were scheduled to elective operation under laparoscopic surgery from October 2010 to June 2012 were randomly divided into three groups .After endotracheal intubation , different carbon dioxide pressures , 10 mm Hg, 12 mm Hg, and 15 mm Hg, were orderly given to group 1, 2, and 3 to build pneumoperitoneum .The serum levels of IL-1β, IL-6, and TNF-α, as well as hemodynamic parameters , were assessed at the time after anesthesia ( T0 ) , after pneumoperitoneum development ( T1 ) , of position placement before operation ( T2 ) , after dismissing pneumoperitoneum (T3), and 24 hours after operation (T4), respectively. Results The measures of MAP, HR, and PETCO2 had no significant differences between each other of the three groups ( P >0.05), and the MAP and HR results showed significant differences among the three groups at different time points (P<0.05) whereas no difference for PETCO2 values (P>0.05).There were statistical significances between the three groups in levels of IL-1β, IL-6, and TNF-αat time points of T1 , T2 , T3 , and T4 , respectively (P<0.05).As compared with T0, there were significant differences in levels of IL-1βat the time points of T1 and T2 in the three groups (P<0.05).There were no significant differences in IL-6 levels between the group 1 and group 2 at every time points (P>0.05).In the group 3, the levels of IL-6 were significantly higher at time points of T 1, T2, and T3 than at T0(P<0.05).In the group 2 and group 3, the levels of TNF-αat T1, T2, and T3 were significantly different from at T0(P<0.05), whereas in the group 1, significant difference was seen only between the time points of T 0 and T1(P<0.05). Conclusion Low pneumoperitoneum pressure leads to minor stress effects .A 10 mm Hg carbon dioxide pneumoperitoneum is recommended .
