Background: The purpose of this randomised, single-centre study was to prospectively investigate the impact of\nanaesthetic techniques for craniotomy on the release of cytokines IL-6, IL-8, IL-10, and to determine whether\nintravenous anaesthesia compared to inhalational anaesthesia attenuates the inflammatory response.\nMethods: The study enroled 40 patients undergoing craniotomy, allocated into two equal groups to receive either\nsevoflurane (n = 20) or propofol (n = 20) in conjunction with remifentanil and rocuronium. The lungs were ventilated\nmechanically to maintain normocapnia. Remifentanil infusion was adjusted according to the degree of surgical\nmanipulation and increased when mean arterial pressure and the heart rate increased by more than 30 % from\nbaseline. The depth of anaesthesia was adjusted to maintain a bispectral index (BIS) of 40ââ?¬â??60. Invasive haemodynamic\nmonitoring was used. Serum levels of IL-6, IL-8 and IL-10 were measured before surgery and anaesthesia, during\ntumour removal, at the end of surgery, and at 24 and 48 h after surgery. Postoperative complications (pain, vomiting,\nchanges in blood pressure, infection and pulmonary, cardiovascular and neurological events) were monitored during\nthe first 15 days after surgery.\nResults: Compared with patients anaesthetised with sevoflurane, patients who received propofol had higher levels of\nIL-10 (p = 0.0001) and lower IL-6/IL-10 concentration ratio during and at the end of surgery (p = 0.0001). Both groups\nshowed only a minor response of IL- 8 during and at the end of the surgery (p = 0.57).\nConclusions: Patients who received propofol had higher levels of IL-10 during surgery. Neither sevoflurane nor\npropofol had any significant impact on the occurrence of postoperative complications. Our findings should incite\nfuture studies to prove a potential medically important anti-inflammatory role of propofol in neuroanaesthesia
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