Effects of General Anesthesia vs. General Anesthesia and Paravertebral Block to IL-2, IL-6, PGE2, MMP-9, and Clinical Outcome in Modified Radical Mastectomy
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Anesthesia, Local
- Sponsor
- Udayana University
- Enrollment
- 88
- Locations
- 1
- Primary Endpoint
- Concentration of IL-2 in blood serum
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Regional anesthesia and analgesia may maintain immune function, reduce surgical stress, and also reduce volatile anesthetics and opioids requirements. Local anesthetic drugs used in regional anesthesia and analgesia work to have anti-proliferative and cytotoxic effects on cancer cells. Pro-inflammatory cytokines such as IL-1, IL-6, and TNF-alpha increase in levels in peripheral nerves, spinal cord, brain (brain stem, locus sereleus, thalamus, hippocampus, and prefrontal cortex) after peripheral nerves are injured. The anti-inflammatory cytokine IL-10 is decreased in levels after peripheral nerve injury. The balance between pro-inflammatory and anti-inflammatory cytokines affects the severity of pain.
Investigators
Christopher Ryalino
Lecturer
Udayana University
Eligibility Criteria
Inclusion Criteria
- •Patient with breast cancer (stadium Ia, Ib, IIa, IIb, IIIa, IIIb) undergoing MRM surgery
- •Balinese race
- •ASA physical status I, II, III
Exclusion Criteria
- •History of allergy to drugs used in anesthesia
- •History psychiatric disorder
- •History of perioperative transfusion
- •History of autoimmune disease
- •History of taking beta blockers or anti-platelet aggregation medications
- •Previous breast surgery
- •Spine deformity
- •Coagulopathy
- •Local infections in paravertebral block site
- •Decreased renal function
Outcomes
Primary Outcomes
Concentration of IL-2 in blood serum
Time Frame: 24-hours after surgery
Concentration of IL-2 level in blood serum
Visual Analog Scale (VAS)
Time Frame: 24-hours after surgery
pain score measured by visual analog scale (VAS), scaled between 0 (no pain) and 10 (worst pain)
Concentration of IL-6 in blood serum
Time Frame: 24-hours after surgery
Concentration of IL-6 level in blood serum
Secondary Outcomes
- Concentration of MMP-9 level in blood serum(24-hours after surgery)
- Concentration of PGE2 level in blood serum(24-hours after surgery)