The Effect Of Permissive Hypercapnia On Cytokines In Patients With Total Laparoscopic Hysterectomy

Objective To explore the value of permissive hypercapnia on gynecological Laparoscopic hysterectomy and the effect on interleukin-6(IL-6), interleukin-10(IL-10) & tumor necrosis factor-alpha(TNF-α) in the patients.Methods 46 selective gynecological Laparoscopic hysterectomy patients were divided into control group (C group,23 cases)& permissive hypercapnia group(P group,23 cases) randomly.After Anesthesia induction,the mechanical ventilation was adjusted by PaCO2 and pH value,maintaining PaCO2 and pH value between 45～60mmHg & 7.25～7.35 in PHC group,which were maitained 35-45mmHg & 7.35～7.45 in C group.The blood pressure,heart rate,blood gas analysis and IL-6,IL-10, TNF-a concentration were recorded at To(before anaesthesia induction),Ti(after anaesthesia induction),T2(0.5 hour afer pneumoperitoneum),T3(1 hour afer pneumoperitoneum),T4(2 hours afer pneumoperitoneum),T5(end pneumoperitoneum for 0.5 hour),T6(end pneumoperitoneum for 1 hour).Results There were no significance difference in age,body weight,the period of pneumoperitoneum,operaion time and extubation time between C group and PHC group patients(P>10.05);The MAP of C group at T5 and T6 was higher than P group,which the difference was statistical significant(P< 0.05);The heart rate of P group at T2 was higher than C group, which the difference was statistical significant (P<0.05 or P< 0.01); Within P group,the IL-6, TNF-a level was lower at the point T2-T6,which the difference was statistical significant(P<0.05 or P<0.01). There were no significance difference in IL-10 between two groups(P> 0.05).Conclusion While undertaking laparoscopic hysterectomy under permissive hypercapnia, the IL-6, TNF-a level was lower than the normal ventilation group,it suggested that this kind of ventilation was probably suitable for the maintenance of anesthesia of similar operation.