Table 1.
The relationship between the general anesthesia and postoperative systemic inflammatory response in patients undergoing different types of surgery in the context of a randomized controlled trial
| Author (s) | Country | Type of surgery | Severity of surgery | Patients (n) |
Anaesthetics used | Inflammatory response marker | Post-operative sampling point | Findings | Comments | Quality of study |
|---|---|---|---|---|---|---|---|---|---|---|
| [19] | Egypt | Minor elective surgery. | Minor | 40 | Halothane group. Isoflurane group. |
IL-6⁎ | 24 h | Halothane group, IL-6 = 30 pg/mL Isoflurane group, IL-6 = 31 pg/mL |
No significant difference between groups. | Low range of quality score. |
| [20] | Germany | Minimal invasive partial diskectomy. | Moderate | 48 | TIVA§ with propofol and sufentanil compared with BAL§ with sevoflurane. | IL-6 | 24 h | TIVA, IL-6 = 15 pg/mL, P < .05 BAL, IL-6 = 35 pg/mL, P < .05 |
Significant reduction in IL-6 in TIVA group versus BAL group. | Low range of quality score. |
| [12] | China | Open cholecystectomy. | Moderate | 40 | TIVA with propofol and remifentanil compared with BAL|| with isoflurane. |
IL-6 | 12 h | TIVA group, IL-6 = 13.7 ± 4.5 pg/mL, P < .001 IA group, IL-6 = 15.5 ± 5.2 pg/mL, P < .001 |
Significant reduction in IL-6 in TIVA versus IA group. | Low range of quality score. |
| [21] | Sweden | Colorectal cancer. | Moderate | 50 | TIVA with propofol and remifentanil compared with inhalational anaesthesia with sevoflurane and fentanyl. | IL-6 | 24 h | TIVA, 24 h, IL-6 = 505 (129.4-1370) pg/mL. Inhalational, 24 h, IL-6 = 370 (198-810) pg/mL. |
No significant difference between groups. | Low range of quality score. |
| [22] | Brazil | Otorhinological surgery. | Minor | 34 | TIVA with propofol compared with inhaled anaesthesia with isoflurane. | IL-6 | 24 h | Propofol, 24 h, IL-6 = 22 pg/mL Isoflurane, 24 h, IL-6 = 20 pg/mL |
No significant difference between groups. | Low range of quality score. |
| [25] | Korea | Cardiopulmonary bypass surgery. | Major | 112 | Group P = propofol with sufentanil. Group S = sevoflurane with sufentanil. |
CRP† | 24 h | Group P, 24 h, CRP = 80 (13.108, (1.483-24.733) mg/L, P = .05 Group S, 24 h, CRP = 120 (13.108, (1.483-24.733) mg/L, P = .05 |
Significant reduction in CRP in group P versus group S. | Low range of quality score. |
| [23] | Romania | Colorectal cancer. | Moderate | 60 | TIVA with propofol compared with inhalational anaesthesia with isoflurane. | IL-6 | 24 h | TIVA + propofol, 24 h, IL-6 = 88 (5.8-349) pg/mL, P = .6 Inhalational, 24 h, IL-6 = 101(23-428) pg/mL, P = .6 |
No significant difference between groups. | Low range of quality score. |
| [24] | UK | Cardiopulmonary bypass surgery. | Major | 40 | Group P = Propofol and fentanyl group. Group I = Isoflurane and fentanyl group. |
IL-6 | 24 h | Group P, 24 h, IL-6 = 25.8 (4.4) pg/mL, P < .001 Group I, 24 h, IL-6 = 34.5 (6.1) pg/mL, P < .001 |
Significant reduction in IL-6 in group P versus group I. | High range of quality score. |
| CRP | 24 h | Group P, 24 h, CRP = 15.7 (4) mg/L, P < .001 Group I, 24 h, CRP = 25.8 (3.2) mg/L, P < .001 |
Significant reduction in CRP in group P versus group I. | |||||||
| [26] | Japan | Thoracoabdominal esophagectomy. | Major | 20 | Group P = propofol anaesthesia followed by propofol sedation. Group S = sevoflurane anesthesia followed by midazolam sedation. |
CRP | 48 h | Group P, 48 h, CRP = 143 ± 3.9 mg/L, P < .05 Group S, 48 h, CRP = 204 ± 4 mg/L, P < .05 |
Significant reduction in CRP in group P versus group S. | Low range of quality score. |
| [28] | China | Open esophagectomy | Major | 30 | TIVA with propofol compared with dexmedetomedine. | IL-6 | 24 h | TIVA + propofol, 24 h, IL-6 = 310 pg/mL, P < .05 Dexmedetomedine, 24 h, IL-6 = 180 pg/mL |
Significant reduction in IL-6 in dexmedetomedine group versus TIVA + Propofol group. | Low range of quality score. |
| [29] | Brasil | Mini-cardiopulmonary bypass surgery. | Major | 23 | TIVA + DEX ‡ group = Propofol, sufentanil and DEX. TIVA group = propofol and sufentanil. |
IL-6 | 24 h | TIVA + DEX group, 24 h, IL-6 = 130 pg/mL, P < .0001 TIVA group, 24 h, IL-6 = 160 pg/mL, P < .0001 |
Significant reduction in IL-6 in TIVA + DEX group versus TIVA group. | High range of quality score. |
| CRP | 24 h | TIVA + DEX group, 24 h, CRP = 150 mg/L TIVA group, 24 h, CRP = 120 mg/L |
No significant difference between groups. | |||||||
| [27] | China | Tibial fracture surgery. | Moderate | 60 | Control group = patients received propofol with remifentanil. Etomidate group = patients received etomidate with remifentanil. |
IL-6 | 24 h | Control, 24 h, IL-6 = 9000 ± 0.48 pg/mL, P = .001 Etomidate, 24 h, IL-6 = 3240 ± 1.24pg/mL, P = .001 |
Significant reduction in IL-6 in etomidate group versus control group. | Low range of quality score. |
⁎IL-6, Interleukin 6; †CRP, C-reactive protein; ‡DEX, dexmedetomedine; §TIVA, total intravenous anesthesia; ||BAL, balanced inhalational anesthesia.