[Effects of prostaglandin E1 on plasma cytokine levels during pneumonectomy]

We investigated the effect of prostaglandin E1 (PGE1) on intraoperative cytokine responses and the incidence of postoperative complications. Twenty-six patients undergoing elective pneumonectomy were randomly allocated into PGE1 group (n = 12) and control group (n = 14). The PGE1 group received continuous infusion of PGE1 during surgery at a dose of 0.02-0.03 microgram.kg-1.min-1. Blood samples were obtained after induction of general anesthesia, one and two hours after incision, and immediately after the end of surgery to measure the plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-8 (IL-8). Levels of CRP for two days after the surgery were measured and postoperative complications were recorded. Levels of TNF-alpha rose from 1.6 pg.ml-1 (mean) to 4.8 pg.ml-1 two hr after incision in the control group, while the level was suppressed in the PGE1 group (P < 0.05). No significant difference was found in IL-6 levels between the two groups. The IL-8 increased during surgery in both groups but the increase was significantly less in the PGE1 group (P < 0.05). There was no difference in CRP, and no severe postoperative complication was observed. We conclude that PGE1 administration suppresses TNF-alpha and IL-8 responses during pneumonectomy, but its effects on IL-6 and the postoperative status were not significant.