Effects of isoflurane-induced and prostaglandin E₁-induced hypotension on cytokine responses to oral and maxillofacial surgery

Study objective To evaluate the effect of induced hypotension with isoflurane or prostaglandin E₁ (PGE₁) on cytokine responses to surgery. Design Prospective, randomized study. Setting University hospital. Patients 24 ASA physical status I and II patients undergoing elective oral and maxillofacial surgery. Interventions Patients were randomly allocated to three groups be anesthetized in the normotension (Control group), isoflurane-induced hypotension (Isoflurane-H group), and PGE₁-induced hypotension (PGE₁-H group). Mean arterial pressure during hypotension was maintained at approximately 80% of baseline values. Measurements and main results Blood samples were taken before induction of anesthesia and during and after hypotension. Plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels were measured using enzyme-linked immunosorbent assay. There were no differences in TNF-α or IL-10 levels among the groups. However, the elevation of the plasma IL-6 level in the PGE₁-H group was found during hypotension, compared with the control group (p < 0.05). Conclusions PGE ₁-induced hypotension has an effect on IL-6 response to oral and maxillofacial surgery.