Influence of Anaesthetic Techniques on Inflammatory Response and Stress Biomarkers in Patients Undergoing Gynaecologic Oncology Surgeries

Q: What was the main objective of the study?

To compare TIVA versus inhalational anesthesia in influencing perioperative levels of IL-6, CRP, cortisol, and epinephrine in patients undergoing gynecologic oncology surgeries.

Q: How were patients assigned to anesthesia groups?

Eighty ASA I–II female patients were randomized into two groups: Group T received TIVA (propofol and remifentanil) and Group I received inhalational anesthesia (sevoflurane and fentanyl).

Q: Which anesthesia technique showed better postoperative outcomes?

TIVA showed lower IL-6 and CRP levels at T1 and T2, reduced cortisol at T1, better hemodynamic control, and fewer episodes of postoperative nausea and vomiting.

Sep 30, 2026

Uploaded by LangkahRina

Gynecologic oncology surgeries are linked to extensive physiological stress and a systemic inflammatory response, with cytokines and stress mediators affecting morbidity, immunosuppression, recovery, and potentially longer-term oncologic events. A prospective randomized study enrolled 80 ASA I–II female patients aged 35–65 undergoing gynecologic oncology operations. Patients received either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and fentanyl). Blood IL-6, CRP, cortisol, and epinephrine were measured preoperatively, immediately after surgery, and 24 hours postoperatively. TIVA reduced IL-6 and CRP at T1 and T2, lowered cortisol at T1, improved hemodynamic control, and decreased postoperative nausea and vomiting.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Abstract

Introduction

Materials and Methods

Original Research Influence of Anaesthetic Techniques on Inflammatory Response and Stress Biomarkers in Patients Undergoing Gynaecologic Oncology Surgeries Aditya S. Chauhan1, Nancy Ekka2, Divya Sinha3, Sourabh Shrivastava1 1Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India, 2Department of Anaesthesia, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India, 3Department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India Submitted: 04‑Aug‑2025 Revised: 13‑Aug‑2025 Accepted: 19‑Aug‑2025 Published: 17‑Dec‑2025 Abstract Background: Gynecologic oncology surgeries are often extensive and associated with significant physiological stress and inflammation. Anesthetic technique may modulate perioperative immune and stress responses, potentially influencing postoperative outcomes. Methods: A prospective, randomized clinical study was conducted on 80 patients (aged 35–65 years) undergoing gynecologic oncology surgeries. Patients were randomly assigned to two groups: Group T (TIVA with propofol and remifentanil) and Group I (IA with sevoflurane and fentanyl) . Blood samples were collected preoperatively (T0), immediately after surgery (T1), and 24 hours postoperatively (T2) to measure interleukin‑6 (IL‑6), C‑reactive protein (CRP), cortisol, and epinephrine levels. Hemodynamic stability and postoperative complications were also evaluated. Results: IL‑6 and CRP levels were significantly lower in Group T at T1 and T2 (IL‑6 at T2: 65.3 ± 12.4 pg/mL vs. 94.1 ± 14.8 pg/mL, P < 0.001; CRP at T2: 3.9 ± 0.7 mg/dL vs. 5.6 ± 1.1 mg/dL, P < 0.001) . Cortisol and epinephrine levels were also significantly reduced in Group T at T1 (cortisol: 422.6 ± 60.3 nmol/L vs. 569.7 ± 82.1 nmol/L, P < 0.01) . Group T demonstrated better hemodynamic control and fewer postoperative nausea and vomiting episodes. Conclusion: TIVA attenuated the inflammatory and stress biomarker response more effectively than inhalational anesthesia in patients undergoing gynecologic oncology surgeries. TIVA may offer potential benefits in perioperative immune modulation and recovery in this patient population. Keywords: Anesthetics, biomarkers, gynecology, inflammatory response Introduction Mgynecologic domain, are associated with ajor oncologic surgeries, particularly in the significant surgical stress that triggers a systemic inflammatory response. This cascade includes the release of cytokines such as interleukin‑6 (IL‑6), acute‑phase reactants like C‑reactive protein (CRP), and stress hormones including cortisol and catecholamines.[1] These mediators are closely linked to perioperative morbidity, immunosuppression, delayed recovery, and possibly cancer recurrence.[2] Anesthetic agents can modulate immune and stress responses. Inhalational anesthetics such as sevoflurane have been shown to influence leukocyte activity | Access this article online | | | --- | --- | | Quick Response Code:
| Website: [https://journals.lww.com/jpbs](https://journals.lww.com/jpbs) | | | DOI: 10.4103/jpbs.jpbs_1356_25 | and oxidative stress,[3] whereas total intravenous anesthesia (TIVA) using propofol has demonstrated antioxidant and anti‑inflammatory properties.[4] Thereis increasing interest in exploring whether the choice of anesthetic technique can affect perioperative inflammatory biomarkers and stress hormone levels, potentially impacting long‑term oncological outcomes.[5] Previous studies have produced mixed results. Some report that TIVA may reduce IL‑6 and cortisol release | Address for correspondence: Dr. Sourabh Shrivastava, Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.
E-mail: [sourabh_jitu@ymail.com](sourabh_jitu@ymail.com) | | --- | | This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download

FAQs

What was the main objective of the study?

To compare TIVA versus inhalational anesthesia in influencing perioperative levels of IL-6, CRP, cortisol, and epinephrine in patients undergoing gynecologic oncology surgeries.

How were patients assigned to anesthesia groups?

Eighty ASA I–II female patients were randomized into two groups: Group T received TIVA (propofol and remifentanil) and Group I received inhalational anesthesia (sevoflurane and fentanyl).

Which anesthesia technique showed better postoperative outcomes?

TIVA showed lower IL-6 and CRP levels at T1 and T2, reduced cortisol at T1, better hemodynamic control, and fewer episodes of postoperative nausea and vomiting.

Sep 30, 2026

Uploaded by LangkahRina