@article {5959,
	title = {A randomized study of maternal serum cytokine levels following cesarean section under general or neuraxial anesthesia},
	journal = {International Journal of Obstetric Anesthesia},
	volume = {18},
	year = {2009},
	month = {2009///},
	pages = {33 - 37},
	abstract = {Background: Cytokines are significant mediators of the immune response to surgery and also play a role in parturition. The aim of the study was to investigate the impact of the anesthetic technique for cesarean section on plasma levels of cytokines IL-6 and TNF-α. Methods: Thirty-five parturients scheduled for elective cesarean section were randomly assigned to general (n = 18) or neuraxial (n = 17) anesthesia. The general anesthesia group received thiopental 4 mg/kg, succinylcholine 1-1.5 mg/kg and 1\% end-tidal concentration of sevoflurane in nitrous oxide and 50\% oxygen. The neuraxial anesthesia group received intrathecal 0.5\% levobupivacaine 1.8-2.2 mL and epidural fentanyl 1 μg/kg. Blood samples were taken for IL-6 and TNF-α immediately after positioning the parturient on the operating table, after uterine incision and before the umbilical cord clamping and 24 h after surgery (T1, T2 and T3 respectively). Results: The two groups did not differ in IL-6 (P = 0.15) or TNF-α (P = 0.73) serum concentrations at any time point. In the general and neuraxial anesthesia groups, IL-6 serum concentrations were significantly higher in the third blood sample, T3 (12.2 {\textpm} 5.0 and 15.2 {\textpm} 4.3 pg/mL), than in T1 (0.41 {\textpm} 0.38 and 0.29 {\textpm} 0.10 pg/mL) and T2 (0.37 {\textpm} 0.47 and 0.24 {\textpm} 0.05) respectively (P < 0.001). Within each group, serum TNF-α concentrations did not differ significantly over time (P = 0.44). Conclusions: Under the present study design anesthetic technique did not affect IL-6 or TNF-α concentrations in parturients undergoing elective cesarean section. Serum IL-6 levels increased 24 h postoperatively independently of anesthetic technique. {\textcopyright} 2008 Elsevier Ltd. All rights reserved.},
	keywords = {Cesarean Section, Cytokines, General anesthesia, IL-6, Neuraxial anesthesia, TNF-α},
	author = {Dermitzaki, E. and Staikou, C. and Petropoulos, G. and Rizos, D. and Siafaka, I. and Fassoulaki, A.}
}
