Interleukin-10 production during and after upper abdominal surgery

Study Objective: To evaluate the influence of major abdominal surgery on the plasma levels of interleukin-10 (IL-10). Design: Prospective study. Setting: University hospital. Patients: 10 ASA physical status I and II patients undergoing upper abdominal surgery. Interventions: All patients received combined general-epidural anesthesia with isoflurane and nitrous oxide, after insertion of an epidural catheter at T-8-T-9 dosed with 1.5% lidocaine. Measurements and Main Results: Plasma interleukin-6 (IL-6), interleukin-8 (IL-8) and IL-10 levels were determined with an enzyme-linked immunosorbent assay at preanesthesia, 0, 2 and 4 hours during surgery, and at the end of surgery, followed by sampling on the morning of postoperative days 1 (POD1) and 3 (POD3). Before anesthesia and at 0 hours of surgery, IL-10 was not detected. In all ten patients, the plasma levels of IL-10 showed significant elevations and achieved their maximal value 4 hours after-the skin incision (p <0.05 vs. baseline). The plasma IL-10 levels returned to preanesthesia levels on POD3. The plasma levels of IL-6 and IL-8 also increased in the perioperative period. The peak cytokine levels correlated (r = 0.915, p = 0.0001 for IL-6 vs. IL-8; r = 0.82, p = 0.025 for IL-6 vs. IL-10; and r = 0.641, p = 0.06 for IL-8 vs: IL-10). The peak plasma IL-10 levels significantly correlated with the amount of intraoperative blood loss (r = 0.69, p <0.05). Conclusions: In patients undergoing major abdominal surgery, plasma IL-10 levels were elevated during and after operation. IL-10 may modulate the inflammatory responses in the perioperative period. (C) 1998 by Elsevier Science Inc.