Background:
This study was purposed to compare in vitro the volumetric accuracy of a newly introduced
automatic infusion controller, AutoClamp with that of other commonly used infusion devices.
Methods:
In this prospective, randomized, controlled trial, 124 ASA I-II, female patients, aged 30-50 years,
undergoing conservative breast cancer surgery were randomly assigned to one of four equal groups receiving either
standard general anesthesia and two doses of hydrocortisone (Group GH, n=31), thoracic paravertebral block and two
doses of hydrocortisone (Group PH, n=31), standard general anesthesia with no hydrocortisone (Group G, n=31), or
thoracic paravertebral block with no hydrocortisone (Group P, n=31). IL-6 was measured at three time points: before
operation, 6 and 12 hours postoperatively. CRP and cortisol were measured preoperatively and 6 hours postoperatively.
Results:
On comparing group PH and GH, there was significant decrease in IL-6 level in group PH compared to group GH
at 6 hour (122.1±21.2 vs 135.8±29.8pg/dl), but insignificant difference at 24 hours (107.9±21.6 vs 106.8±15.9pg/dl). CRP
showed significant decrease in the postoperative reading in group PH compared to group GH (1.63±0.32 vs
1.91±0.43mg/l), and also group PH showed significant decrease compared to the control group P (1.63±0.32 vs 2.2±0.54).
Conclusion:
addition of hydrocortisone to general anesthesia or thoracic paravertebral block attenuated production of IL-6
and CRP levels significantly postoperatively compared to either anesthetic regimen alone, but not the serum cortisol level,
highlighting its role in modifying the stress response to surgery. However, the effect was more pronounced when
combined with thoracic paravertebral block.
Paravertebral block in regional anesthesia with propofol sedation reduces locoregional recurrence in patients with breast cancer receiving breast conservative surgery compared with volatile inhalational without propofol in general anesthesia
