Comparison of inflammatory response and stress response in anesthesia techniques of general endotracheal anesthesia with combined epidural general anesthesia in colorectal surgery procedures

BACKGROUND: Colorectal surgery is a surgical procedure that is required to treat various problems along the intestine, especially in the rectum, anus and colon. Surgical procedures cause metabolic stress response and release of inflammatory cytokines (IL-6). Appropriate selected anesthesia is expected to suppress metabolic stress and excessive inflammatory response resulting in good clinical outcomes. This study aimed to compare the inflammatory response and neuroendocrine stress response in General Endotracheal Anesthesia (GETA) technique with Combined Epidural General Anesthesia (CEGA) in colorectal surgery procedures at Dr. Wahidin Sudirohusodo Hospital Makassar.METHODS: Randomized clinical trial involving 24 samples divided into 2 groups, including GETA group (N.=12) and CEGA group (N.=12).RESULTS: In the GETA group, there was a significant increase in postoperative IL-6 (P=0.009) and cortisol (P=0.014) levels. There was no significant change in IL-6 (P=0.797) and cortisol (P=0.061) levels in the CEGA group. IL-6 and cortisol levels at 6 hours postoperatively were found to be significantly higher in the GETA group (P=0.049 and P=0.019). No significant difference in length of stay (P=0.909) and postoperative pain intensity (P=0.800) between the groups.CONCLUSIONS: CEGA anesthesia technique is able to suppress postoperative cortisol and IL-6 release more effectively than GETA anesthesia.