The Immune Modulation of Bilateral Paravertebral Block and Propofol in Spine Surgery.
Status:
Completed
Trial end date:
2020-09-01
Target enrollment:
Participant gender:
Summary
General anesthesia has an important effect on inflammatory cytokines. Inhalational agents as
isoflurane and sevoflurane attenuate immune function expressed by neutrophil
chemoattractant-1 as well as inflammatory enzyme and also they reduce inflammatory cascade.
Total intravenous anesthesia (TIVA) based on using propofol suppresses the inflammatory
response caused by surgery to a greater extent because Propofol affects the balance between
pro-inflammatory and anti-inflammatory cytokines, increasing production of the
anti-inflammatory cytokine IL-10 and at the same time reducing the increase of IL-6 during
the perioperative period. It also alters expression of nitric oxide and inhibits neutrophil
function. TIVA has many advantages such as; fewer side effects, earlier discharge, better
patient satisfaction, faster recovery, less nausea and vomiting and reduced muscle relaxant
requirements. Paravertebral block has an important role in the inflammatory and immune
response. The paravertebral block can decrease perioperative inflammation and prevent immune
suppression. Also, it can attenuate the cytokine response and reduce acute stress response
caused by surgery. Decrease inflammation processes, improve surgery result, limit the
duration of hospital stay, decrease post-operative fatigue and reduce postoperative
complications.