Abstract: [Abstract] objective To study the changes of serum IL-6,IL-10,TNF-αand heat shock protein 70(HSP70)in patients underwent gynecological laparoscopic operations using carbon dioxide pneumoperitoneum or abdominal wall-lifting methods under different anesthesia. Methods Fifty-seven patients scheduled for gynecological laparoscopy from July 2005 to February 2006, ASAⅠ~Ⅱ, whose operation time was short of 100 min, were randomly divided into three groups(Ⅰ,Ⅱ,Ⅲ)with 19 cases in each group respectively. Group Ⅰ patients were operated with the aid of CO2 insufflation under general anesthesia.GroupⅡ patients were operated under general anesthesia and gasless technique. Group Ⅲ patients went through the same operative procedures under epidural anesthesia and gasless technique. Monitoring for all patients included the serum IL-6,IL-10,TNF-α and HSP70 at four points: before anesthesia(T1),at 30min after the beginning of the operations(T2) and 10min after the end of the surgery(T3)and at 8 AM in the following day(T4).Results There were no obvious difference regarding the serum IL-6,IL-10,TNF-α and HSP70 among the three groups at T1(P>0.05), and these values increased after the beginning of the operations,which reached to their peak values in groupⅠat T3 and in group Ⅱ and in group Ⅲ at T4. The levels of serum TNF-α were higher in groupⅠ than those in group Ⅱ at T2(P<0.05). At T3 point,levels of serum IL-6,TNF-α and HSP70 were significantly higher in groupⅠthan those in group Ⅱ (P<0.01), and was the same as the ratio of IL-6/IL-10(P<0.05). Meamswhile, serum concentrations of the serum IL-6 and TNF-αwere also significantly higher in group Ⅱ than those in group Ⅲ (P<0.05).Conclusion Gynecological laparoscopic operation using abdominal wall-lifting methods could avoid the effect of CO2 pneumoperitoneum, reduce the stress response during operation and the least stress response was seen in the abdominal wall-lifting methods under epidural anesthesia.
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