Impact of Two Different Anesthetic Techniques on Immune Response and Postoperative Pain for Abdominal Hysterectomy

Abstract
Background: Spinal anesthesia is a famous technique used for lower abdominal surgery, however when it is con-traindicated, general anesthesia can be used.
Aim of Study: The aim of this study was to evaluate the impact of anesthetic techniques on immune response and postoperative pain for patients undergoing benign abdominal hysterectomy.
Material and Methods: Forty adult female patients (Amer-ican physical status (ASA) I-II, 30-60 years) scheduled for abdominal hysterectomy (AH) were allocated to receive either general or spinal anesthesia. Hemodynamic variables were recorded and blood samples were collected for analysis of [Tumor necrosis factor (TNF), Interlucin-6 (IL-6) and Inter-lucin-10 (IL-10)] levels. Also, Visual Analog Scale (VAS) for postoperative pain with surgeon and patients satisfaction were recorded.
Results: Serum analysis of IL-6 and TNF showed signif-icant increase 30min after induction of anesthesia and 4 hours postoperatively in Spinal group (p<0.001), while IL-10 showed significant increase 4 hours postoperatively in general group (p=0.0001). VAS was lower in Spinal group than general group (p=0.027), with higher patients and surgeons satisfaction scores in spinal group (p=0.0305) & (p=0.0803) compared with general group.
Conclusion: Our study concluded that spinal anesthesia increase proinflammatory cytokine IL-6 and TNF during and after surgery, thus stimulating cell immunity and improve postoperative analgesia with better surgeon and patients satisfaction than general anesthesia.