Anesthetic Approaches in Obese Patients: A Pilot Study Comparing the Impact of Desflurane versus Propofol on IL 6 Levels in Bariatric Surgery

Objective: Anesthetic and surgical stress may complicate the delicate immune state of obese patients. The immunomodulatory potential of anesthetics may play a role in minimizing complications. This study evaluates desflurane versus total intravenous anesthesia (TIVA) with propofol on surgical stress response in patients undergoing laparoscopic bariatric surgery, comparing interleukin-6 (IL-6) levels as a marker of neuroendocrine stress response between groups. Methods: Thirty adult patients aged 18-75 years, who underwent laparoscopic bariatric surgery, were studied in this prospective, randomized, single-blinded pilot study. Participants were randomly assigned to receive either desflurane (Group D) or propofol (Group P) anesthesia. Blood samples were collected after induction and extubation for the IL-6 assay. The investigator analyzing IL-6 levels was blinded to group allocations. Results: IL-6 increase was not significantly different between patients receiving desflurane or propofol. The choice of surgical procedure and its duration significantly impacted the inflammatory response. Other recovery parameters and adverse events did not differ significantly between the groups, except for nausea which was higher in the desflurane group. Conclusion: Both desflurane and TIVA with propofol are viable options for managing anesthesia in obese patients, with each having distinct advantages.