| Objective To evaluate the effect of acute normovolemic hemodilution on the change in perioperative serum IL-6, IL-10, TNF- a and the balance between pro- and anti-inflammatory cytokines during hepatic cancer surgery. Methods Twenty-six ASA I - II patients scheduled for hepatic cancer surgery were randomly allocated to one of the two groups: control group( I group) and hemodilution group(II group). Blood samples were taken from internal peripheral vein before anesthesia (To), prior to retransfusion of blood components (Ti), after the retransfusion of blood components (T2), 2h(T3), 4h(T<), 6h(T5), 24h(T6) after operation for determination of serum IL-6 , IL-10 and TNF- a concentrations. Results (1) in control group, serum TNF- a concentration decreased significantly after the retransfusion of blood components as compared with that before anesthesia(p<0.05). There was no significant change throughout perioperative period in hemodilution group(p>0. 05), but TNF-a levels at T3> T4> T5^ T6were significantly lower in control group than those in hemodilutiongroup(p<0. 05) . (2) All patients showed significant increases in IL-6 levels after surgery and peaked at 4h, 6h after operation(T4, T5).No statistical difference was found between both groups (p>0.05). (3) In both groups, compared with that before anesthesia, IL-10 concentrations increased significantly after surgery(p<0.05 or 0.01),but in control group the IL-10 decreased significantly at 24h after operation(T6). In contrast the hemodilution group still showed significant increases in IL-10 concentration as compared with before anesthesia and group I (p<0.01). Conclusions Acute normovolemic hemodilution do not make the inflammatory reaction heavier, and it can accelelate the secretion of IL-10. Acute normovolemic hemodilution seems to exert less on immune funtion and to maintain the balance of cytokines during cancer surgery.
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