1. The immunomodulatory role of esmolol in patients undergoing laparoscopic gastrectomy due to gastric cancer
- Author
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M.-L. Cho, K.Y. Song, Yang-Mi Her, J.W. Huh, Jae Mun Lee, S.-H. Kang, and Y.S. Kim
- Subjects
Male ,Enzyme-Linked Immunosorbent Assay ,Sodium Chloride ,Immunomodulation ,Propanolamines ,Interferon-gamma ,Intraoperative Period ,Postoperative Complications ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,In patient ,Postoperative Period ,Inflammation ,business.industry ,Interleukin-6 ,Laparoscopic gastrectomy ,Cancer ,Middle Aged ,medicine.disease ,Esmolol ,Adrenergic beta-1 Receptor Antagonists ,Anesthesiology and Pain Medicine ,Saline group ,T helper 2 ,C-Reactive Protein ,T helper 1 ,Anesthesia ,Heart failure ,Female ,Laparoscopy ,Interleukin-4 ,business ,medicine.drug - Abstract
Summary Esmolol has a beneficial effect on the T helper 1/T helper 2 balance in patients with heart failure. The aim of this study was to investigate the immunomodulatory role of esmolol during and after surgery. Patients undergoing laparoscopic gastrectomy due to gastric cancer were enrolled. Patients in the esmolol group (n = 15) received esmolol during surgery, and a saline-treated group (n = 14) served as a control. Cytokines were quantified by sandwich enzyme-linked immunoassays before, during and after surgery. The esmolol group was associated with higher ratios of interferon-γ/interleukin-4 (T helper 1/T helper 2 signature cytokines) than the saline group during (2.36 vs 0.57, respectively, p = 0.041) and after (5.79 vs 0.69, respectively, p = 0.033) surgery. The postoperative increase in interleukin-6 was attenuated in the esmolol group, and the C-reactive protein level on postoperative day 1 was significantly lower in the esmolol group than in the saline group (mean (SD) 26.2 (18.3) mmol.l−1 vs 56.8 (44.3) mmol.l−1, p = 0.021). Our findings suggest that esmolol played an immunomodulatory role and mitigated the postoperative inflammatory response in patients under surgical and anaesthetic stress.
- Published
- 2013