Study Objective: To evaluate the influence of major abdominal surgery
on the plasma levels of interleukin-10 (IL-10). Design: Prospective st
udy. 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 isofluran
e and nitrous oxide, after insertion of an epidural catheter at T-8-T-
9 dosed with 1.5% lidocaine. Measurements and Main Results: Plasma int
erleukin-6 (IL-6), interleukin-8 (IL-8) and IL-10 levels were determin
ed with an enzyme-linked immunosorbent assay at preanesthesia, 0, 2 an
d 4 hours during surgery, and at the end of surgery, followed by sampl
ing 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 t
he perioperative period. The peak cytokine levels correlated (r = 0.91
5, p = 0.0001 for IL-6 vs. IL-8; r = 0.82, p = 0.025 for IL-6 vs. IL-1
0; 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 bloo
d 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 periop
erative period. (C) 1998 by Elsevier Science Inc.